Introducing the LP Kit: Ensuring every breath post-surgery is a step towards better pulmonary health

At Atos Medical we have an in depth understanding of the importance of high levels of humidification and filtration following a total laryngectomy to replace the function of the nose, and we have continued to innovate and develop a number of high performing HMEs over time.

Following a recent survey of our UK clinicians, we have learnt that the initiation of an HME post operatively can vary from in-theatre placement, to after discharge. This is despite the updated RCSLT laryngectomy position paper from 2023 which recommended “all people with laryngectomy should be considered for early post-operative pulmonary rehabilitation, including considering use of a HME within 24 hours of surgery if possible.”

What is the Laryngectomy Pulmonary Kit (LP Kit)?

As we know from clinical evidence and clinical experience, early placement of an HME has a positive impact not only on the pulmonary health of a patient, but also on their quality of life and HME compliance. The LP is an “all-in-one” kit for use immediately post-op. It has been used in the United States in over 390 facilities, with over 19000 patients in the last decade. It provides the patient with immediate access to appropriate humidification, establishing them on their HME routine from day one. Clinical evidence has shown this reduces suctioning requirements, reduces coughing episodes and reduces the risk of mucus plugging (Merrol et al., 2012, Foreman et al., 2016, Ebersole et al., 2020*).

Our suggestion is that the first HME should be that of the highest level of humidification, as close to nasal breathing as possible. In the Atos range of Provox Life HMEs this would be the Provox life Night HME. This has been the first HME of choice in the United States, and clinical experience shows it allows the patient to adapt to a high resistance HME right from the beginning and in turn improves HME compliance.

Once a good HME routine is established, and your patient is starting to mobilise, then introduce the Provox Life Home HME during the day. This day and night situational use of HMEs will provide your patients with confidence and competence in using their products prior to discharge.

References

• Merol JC, Charpiot A, Langagne T, Hemar P, Ackerstaff AH, Hilgers FJ. Randomizewd controlled trial on postoperative pulmonary humidification after total laryngectomy: External humidifier versus heat and moisture exchanger. Laryngoscope. 2012;122(2):275-81.
• Foreman A, De Santis RJ, Sultanov F, Enepekides DJ, Higgins KM. Heat and moisture exchanger use reduces in-hospital complications following total laryngectomy: a case-control study. J Otolaryngol Head Neck Surg. 2016;45(1):40.
• Ebersole B, Moran K, Gou J, Ridge J, Schiech L, Liu JC, et al. Heat and moisture exchanger cassettes: Results of a quality/safety initiative to reduce postoperative mucus plugging after total laryngectomy. Head Neck. 2020.