Maximal Cardiopulmonary Exercise testing in laryngectomized patients using different HMEs - Feasibility and exercise responses

Objective After laryngectomy, breathing resistance of Heat-and-Moisture-Exchangers (HMEs) may limit exercise capacity. Breathing-gas-analysis during cardiopulmonary exercise testing (CPET) is not possible using regular masks. We tested the feasibility of CPET with an HME in situ, using an in-house designed connector. Additionally, we explored the effect of different HME resistances on exercise capacity in this group. Methods Ten participants underwent two CPETs using their daily life HME (0.6 or 0.3 hPa) and one specifically developed for activity (0.15 hPa). HME order was randomized and blinded. Results All participants completed both tests. No (serious) adverse events occurred. Only 4 subjects reached a Respiratory Exchange Ratio RER1.1 in at least one test. Maximum exercise levels using HMEs with different resistances did not differ. Conclusion CPET in laryngectomees with an HME is feasible, however the protocol does not seem appropriate to reach this groups maximal exercise capacity. Lowering HME resistance does not increase exercise capacity in this sample.