Válvula fonatória brasileira para traqueotomia: padronização de pressão de diafragma

Abstract

Tracheot omy is performed in cases of upper airway obstruction or chronic pulmonary disorders. The Tracheotomy Speech Valves (TSV) improve communication and airway hygiene and humidification of tracheotomized patients. Aim: To show the low cost Brazilian TSV and its use in speech rehabilitation of tracheotomized patients, to evaluate diaphragm opening resistance and comfort to the patient. Study Design: Experimental, contemporary cohort . Materials and methods: The TSV was used in 32 patients. The valve has a diaphragm within a stainless steel body with plastic fittings. We studied the level of respiratory comfort according to the degree of valve diaphragm resistance, 40, 50 and 60 shores. Results: All the patients used the TSV coupled to the cannula in a regular basis, 26 of them did it for more than 12 hours daily and from these, 14 used it for 24h daily. The diaphragm pressure obtained was that of 40 shores for 13 patients and 50 shores for 19 patients. 60 shores was never used. Conclusion: the metal TSV helps with speech without the need for closing the cannula with one's finger, and breathing was comfortable. We achieved standard diaphragm resistance. Currently all the patients from this study use this TSV with speech and 43.75% use it full time.

Carga Global De Doença Sobre a Covid-19 Em Crianças: Uma Revisão Integrativa Da Literatura

“…Trabalhos anteriores revelam que, quando submetidas a treinos e supervisão, crianças traqueostomizadas a partir de 8 meses obtiveram melhora de fala e limpeza pulmonar, através do reflexo de tosse, com uso da VF obtendo boa tolerabilidade (SILVEIRA et al, 2009).…”

“…Este recurso permite a fonação mais espontânea sem necessidade de oclusão digital da cânula de traqueostomia, há uma melhora na condição psicológica do paciente, redução na produção de secreção traqueal, com diminuição de tosse produtiva pela traqueostomia (SILVEIRA et al, 2009. Estudos realizados em 16 pacientes com traqueostomia, submetidos aos exames de videoendoscopia e videofluroscopia compararam entre si dois grupos, os com VF e sem VF. Os resultados obtidos demonstraram melhora significativa da deglutição do grupo com VF, gerando benefícios no reflexo da tosse e resultando na higiene pulmonar dos pacientes (LEDER et al, 2006).…”

A comunicação do paciente traqueostomizado: uma revisão integrativa

“…Among the 32 participants in this study, 43.75% could use it full time, the others removed it for sleeping 13,24 . The presence of a specialized team with a language-speech pathologist showed important results in Montreal, with lower number of calls due to complications, such as tube obstruction; reduction of decannulation time; increase of patients undergoing decannulation from 59.4% to 68.5%, and increase in the placement of speaking valves from 19.4% to 67.4% 25 .…”