Introduction to HMEs – What are Heat and Moisture Exchangers (HME)?

You may have heard a lot about Heat and Moisture Exchangers (HMEs) already, but how much do you really know about them? Let’s look at what they do, and the different HMEs that are available.

HMEs explained

Your HME is placed over your stoma and designed to:

Humidify and heat the air you breathe

Filter out larger particles

Facilitate voicing if you have a voice prosthesis, by closing the stoma when you press on the HME

Special salt to absorb moisture

Your Provox HME contains a foam that has been treated with a special type of salt, called calcium chloride. This traps heat and moisture from the air you breathe out, transferring it to the air you breathe in through your stoma. As this salt dissolves over time, your HME will become less and less effective.

A study shows that HMEs generally last 24 hours based on ‘average usage’ and doesn’t consider environmental conditions (such as polluted air, changes in temperature or relative humidity), breathing patterns (including heavy coughing) and mucus production. If you find yourself in any of these situations, you may need to change your HME more frequently.

HMEs are here to help

The purpose of a HME is just as it sounds - it’s designed to capture moisture and heat when you breathe out (exhale), and as you breathe in (inhale) the heat and moisture is then added to the inhaled air. This humidifies and “conditions” the air – replacing some of the functions that your nose and upper airway used to perform, before a laryngectomy.

How do they work?

During exhalation, warm and moist air is breathed out
The heat and humidity in the exhaled air are saved in the HME foam
During the next inhalation the cold and dry air passes through the HME
The heat and humidity that was saved in the HME, are then released back into the inhaled air
The warm and moist air then enters the airway (windpipe) and travels to the lungs

In other words, HMEs ‘condition’ the air you breathe, by keeping it at a good humidity, and temperature for your airways and lungs to function properly.

Use your HME 24/7

HMEs will become a constant in your life after a laryngectomy. To really benefit it is important to wear your HME 24 hours a day.

Using an HME throughout the day and night helps to:

Improve lung health

Reduce excessive mucus production

Reduce coughing

Reduce sleep disturbances

Improved lung health can also have a positive impact on quality of life.

Speaking with an HME

If you use a voice prosthesis, simply press the HME lid to voice.

DOs and DON’Ts of HMEs

We all have different bodies, so it makes sense that some of us will have to change our HME more regularly than others. The one thing all people with a laryngectomy have in common is the need to constantly wear a HME. That’s why it’s important to know what to do and what not to do when it comes to looking after your HME.

Click here to read on about the DOs and DON’Ts of HMEs.

References

Bien, S., Okla, S., van As-Brooks, C. J., & Ackerstaff, A. H. (2010). The effect of a Heat and Moisture Exchanger (Provox HME) on pulmonary protection after total laryngectomy: a randomized controlled study. Eur. Arch. Otorhinolaryngol, 267(3), 429-435. https://doi.org/10.1007/s00405-009-1018-4 [doi] (Not in File)

Parrilla, C., Minni, A., Bogaardt, H., Macri, G. F., Battista, M., Roukos, R., Pandolfini, M., Ruoppolo, G., Paludetti, G., D'Alatri, L., & de, V. M. (2015). Pulmonary Rehabilitation After Total Laryngectomy: A Multicenter Time-Series Clinical Trial Evaluating the Provox XtraHME in HME-Naive Patients. Ann. Otol. Rhinol Laryngol, 124(9), 706-713. https://doi.org/0003489415579219 [pii];10.1177/0003489415579219 [doi] (Not in File)

Ratnayake, C. B. B., Fles, R., Tan, I. B., Baijens, L. W. J., Pilz, W., Meeuwis, C. A., Janssen-van Det, P. H. E., van Son, R., & Van den Brekel, M. W. M. (2019). Multicenter randomized crossover trial evaluating the provox luna in laryngectomized subjects. Laryngoscope, 129(10), 2354-2360. https://doi.org/10.1002/lary.27839

van den Boer, C., van Harten, M. C., Hilgers, F. J., van den Brekel, M. W., & Retel, V. P. (2014). Incidence of severe tracheobronchitis and pneumonia in laryngectomized patients: a retrospective clinical study and a European-wide survey among head and neck surgeons. Eur. Arch. Otorhinolaryngol, 271(12), 3297-3303. https://doi.org/10.1007/s00405-014-2927- 4 [doi] (Not in File)

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