HME or artificial nose

In the pre-surgery situation, inhaled air was warmed, moistened and cleaned by the nose, mouth and throat. After surgery, air enters the stoma cold, dry and unfiltered. This can irritate the oesophageal and pulmonary mucosa and induce cough reflexes.

Warming, moistening and filtering air can be taken over in part by a heat and moisture exchanger (HME [also termed artificial nose or filter]). By using an HME, the lower airway mucosa is protected and supported, partially preventing thickening of mucus and mucosal infections.

The filter may be attached to a (soft) cannula (22 mm connection) or larytube or in a special plaster (also termed baseplate). Products are often selected by patients in collaboration with the specialised nurse, speech therapist or physician. In order to prevent mucosal infections and mucus thickening, a saline solution can be sprayed or dripped in addition to using a filter. The tracheostoma should generally be cared for 2 to 4 times daily.

A tracheostoma filter (HME or artificial nose) is necessary:

A tracheostoma filter increases resistance on inhalation, increasing lung expansion and oxygen absorption. It also promotes the release of carbon dioxide from the blood. A tracheostoma filter must be used 24 hours a day for optimal effect. A filter should not be used for longer than a day. After one day, bacterial growth starts and heat and moisture regulation deteriorates. As additional protection or for cosmetic reasons, a shawl or poloneck may be used.