Summary of the best evidence for airway humidification management in non-mechanical ventilation patients with tracheotomy after laryngectomy

LUO Mingyue; ZHENG Ting; PAN Le; HAN Minghua; DUAN Xinyu; DING Yongxia

doi:10.12102/j.issn.2095-8668.2025.08.002

Abstract：Objective:To update and summarize the relevant evidence on airway humidification management in patients undergoing tracheotomy without mechanical ventilation after laryngectomy in the past 5 years.Methods:Based on the"6S"evidence pyramid model,the literature on tracheal wetting management after laryngectomy from top to bottom in relevant websites and databases at home and abroad,such as the BMJ Best Practice,UpToDate,and the Joanna Briggs Institute Centre for Evidence-Based Health Care Research in Australia were searched literature on the management of airway wetting in patients with incision non-mechanical ventilation.The time frame for the search was from December 2018 to June 2024.Literature screening,data extraction and evidence summarization were performed independently by 2 researchers.Results:A total of 22 articles were included,including 2 guidelines,6 expert consensus articles,4 evidence summaries,1 evidence-based practice article,3 Meta-analyses,and 6 randomized controlled trials.Ultimately,a total of 25 best pieces of evidence were formed for 8 themes including monitoring and evaluation,fluid management,humidification methods,humidification devices,humidification device fixation,humidification fluids,inspection and evaluation,and humidification operations.Conclusions:On the basis of previous studies,this study proposes that the selection of humidification methods should comprehensively consider factors such as the patient's respiratory function,disease status,activity level,as well as the nature,color,and volume of sputum.Conventional use of humidification droplets is not necessary before and during artificial airway suction,and new perspectives such as prioritizing the use of heat and moisture exchangers and standardized elastic line fixation for humidification tubes are recommended without contraindications or economic limitations.It is suggested that in the future,clinical translation should be carried out based on comprehensive consideration of specific clinical situations and patient wishes,in order to standardize the airway humidification management process and improve airway humidification management measures.