During normal breathing, inspired air is warmed, filtered and moistened by ciliated epithelial cells in the nose and upper airways. However, these humidifying functions are bypassed by a tracheostomy tube or laryngectomy and air inspired will be cold and dry. Inadequate humidification can result in a number of physiological changes which can be serious to the patient and potentially fatal, including:
- Retention of viscous, tenacious secretions
- Impaired mucociliary transport
- Inflammatory changes and necrosis of epithelium
- Impaired cilia activity
- Destruction of cellular surface of airway causing inflammation, ulceration and bleeding)
- Reduction in lung function (e.g. atelectasis/pneumonia)
- Increased risk of bacterial infiltration.
As a result, humidification must be artificially supplemented to assist normal function and facilitate secretion removal. Failure to adequately humidify could result in tube or stoma blockage as secretions become dry and viscous, forming a crust around the tracheostomy.
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