Characteristics of tracheostomy phonation valves

Abstract

Phonation valves are commonly used devices that allow the restoration of speech in tracheostomised patients. However, their use should not compromise the physiological benefit of tracheostomy.Six commercialised phonation valves were studied in a dynamic set-up simulating a respiratory frequency of 20 breaths?min . Additional WOB varied with a ratio of 4.4 between the best and the worst valve. While the different clinical conditions did not modify respiratory patterns and gas exchanges, a significant effect on the Borg scale rating was observed using ANOVA and post hoc analysis of baseline versus worst valve and one of the best valves versus worst valve.In conclusion, the variety of aerodynamic characteristics of phonation valves should be considered when choosing the device, according to the underlying condition of the patients benefiting from their use.

Pressure stability with CPAP devices: A bench evaluation

“…Although imposed WOB may not generate respiratory muscle fatigue in patients without respiratory insufficiency, it may cause discomfort. For example, the levels of imposed WOB seen with some of the devices tested here were associated with major increases in respiratory discomfort in tracheostomized patients [13]. However, data from these patients with severe chronic respiratory failure may not apply to patients with OSA, whose daytime respiratory function is often normal.…”

Tracheostomy tube manometry: evaluation of speaking valves, capping and need for downsizing

“…After educating referring hospitals about tracheostomy tube manometry, they started to use speaking valves with non‐fenestrated tubes. (8) While capping has been recommended only with fenestrated tubes or non‐fenestrated No. 4 tubes, (9) we found that many patients tolerated capping with other tubes.…”

Optimizing speech production in the ventilator‐assisted individual following cervical spinal cord injury: a preliminary investigation

“…This ensures that sufficient subglottic pressure is maintained during both the inspiratory and expiratory ventilator cycles for voice production. While a range of tracheostomy speech valves are available (Prigent et al 2006), only two are US Food and Drug Administration (USFDA) approved for use with a ventilator (Vent‐Trach, Boston Medical Products, Boston, MA, USA [http://www.bosmed.com]; and the Passy–Muir Tracheostomy Speaking Valve (PMTSV); Passy–Muir Inc., Irvine, CA, USA [http://www.passy-muir.com]) with the PMTSV being the most commonly used clinically and in previous research (Dikeman and Kazandjian 2003). In addition to allowing production of complete sentences (Manzano et al 1997), the PMTSV has been reported to improve speech flow, volume, voice quality and speech intelligibility (Passy et al 1993).…”