Survey On Early Period Airway Humidification Among Laryngeal Cancer Patients Underwent Laryngectomy

ObjectiveTo describe the current situation of airway humidification among laryngeal cancer patients underwent laryngectomy within a week after surgery, including humidification method, humidifying solution, humidification fluid volume and humidification effect.MethodsDescriptive-study design. The survey was carried out from September 2012 to April 2013 to describe the current situation of early period airway humidification among laryngectomized patients by using two self-designed questionnaires, which entitled "laryngeal cancer patients’background" and "airway humidification effect questionnaire among laryngeal cancer patients". A convenient sampling method was used to recruit 128 laryngeal cancer patients from four grade A hospitals in shanghai.ResultsResults related to the background of laryngectomized patients and temperature and AH (relative humidity)1、Laryngectomized patients Most of the respondents were male patients (95.5%) and the average age was 60 years(60.2±9.0).97.7% patients were married and over half of the respondents’education degree was under or equal to junior high school. More than half of the respondents had 2000RMB to 5000 RMB per month (71.1%).36.2% patients had comorbidity and most of them got medical insurance (98.4%).98(76.6%) smokers had an average of 30 years (30.6±11.3) smoking and 57(44.5%) drinkers with an average of 28.9 years (28.9±11.4) of alcohol intake. None of the patients had distant metastasis. Above two thirds of the patients accepted partial laryngectomy (68.7%) and less than a quarter had lymph node dissection (21.9%). All the patients had tracheostoma and the majority of patients used metal tracheal tubes (78.9%) within one week after surgery.2、Temperature and AH The average environment temperature of four hospitals ranged from 23.4℃ to 23.8℃,and it was no significant difference within a week after laryngectomy (P>0.05). The average environment AH ranged from 53.66% to 56.37% and there was significant difference between four hospitals 0.05)excepted the sixth day.Results related to the humidification methodsIntermittent tracheal instillation and continuous airway humidification via syringe pump were two common airway moisture methods, which were called intermittent and continuous humidification for short respectively. There was a great difference in humidification operation between four hospitals.A minority of the patients were given no humidification post-operatively.Results related to the humidifying solutionFour hospitals chose the humidification solution based on routine operation and experience, thus there were four different solutions, normal saline, Lincomycin hydrochloride eye drops,20ml normal saline with 4000u chymotrypsin,20ml normal saline and 80000 u gentamycin with 4000 u chymotrypsin.Results related to the humidification fluid volumeThe average median of humidification fluid volume among 128 laryngectomized patients was 19.57ml within a week after surgery, fluid volume had significant difference between four hospitals (P< 0.05). fluid volume of intermittent humidification was more than continuous humidification,and there was no significant difference between two methods except the second day (P<0.05)Results related to the humidification effectThe general humidification effect did not meet the ideal moisture standards, and over half of the patients were under the moisture requirements each day of the first week. Humidification effects showed no significant difference between four hospitals (P>0.05).And the difference between intermittent and continuous humidification was not significant (P> 0.05)ConclusionThere was no universal standard criteria in humidification methods, humidifying solution and humidification fluid volume of laryngeal cancer patients. Humidification effect was not as good as reported. Therefore, there is an urgent necessity to reconstruct the standardizing airway humidification clinical practice guideline of laryngectomized patients in future. Only in this way can we promote the Professional Developments of airway humidification in laryngeal cancer patients and improve current humidification situation.