Effect of a One-Way Tracheotomy Speaking Valve on the Incidence of Aspiration in Previously Aspirating Patients with Tracheotomy

Leder, Steven B.

doi:10.1007/pl00009590

Cited by 60 publications

(55 citation statements)

References 33 publications

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“…20 There are studies, however, showing no influence of occlusion of the external orifice of the tracheostomy cannula on improved aspiration. 10 Speaking valves yield benefits in the coughing reflex and improve lung hygiene in patients.…”

Section: Resultsmentioning

confidence: 99%

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Válvula fonatória brasileira para traqueotomia: padronização de pressão de diafragma

Silveira¹,

Soki²,

Chone

et al. 2009

Rev. Bras. Otorrinolaringol.

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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.

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Section: Resultsmentioning

confidence: 99%

“…3 Regarding the latter, an increased rate of aspiration has been demonstrated in tracheostomized patients. [6][7][8][9][10][11][12][13] Elevation of the larynx is also affected since the cannula fixates the larynx to the skin of the neck. 14 Speaking valves (VF) for tracheostomy have minimized these procedure-associated losses.…”

Section: Introductionmentioning

confidence: 99%

Válvula fonatória brasileira para traqueotomia: padronização de pressão de diafragma

Silveira¹,

Soki²,

Chone

et al. 2009

Rev. Bras. Otorrinolaringol.

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“…Tem-se observado diminuição no grau de aspiração relacionada à traqueotomia após o uso das VF 9,13 . Porém há estudos que demonstram a ausência de influência da oclusão do orifício externo da cânula de traqueotomia com a melhora na aspiração 10 . Produz benefícios no reflexo da tosse e com isso melhora a higiene pulmonar dos pacientes, propiciando a ausência de formação de secreção no traqueotoma.…”

Section: Discussionunclassified

“…Outras funções desenvolvidas pela via aérea superior podem estar comprometidas nos enfermos com traqueotomia como aquecimento, umidificação, filtração do ar, tosse, espirro, paladar, olfato, deglutição 3 . Nesta última, demonstrou-se maior aspiração nos pacientes traqueotomizados 6,7,8,9,10,11,12,13 . Sua fisiopatologia não é bem determinada.…”

Section: Introductionunclassified

Nova válvula fonatória para traqueotomia: uma proposta brasileira

Chone

Bortoleto

Gripp

et al. 2002

Rev. Bras. Otorrinolaringol.

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Introdução:A traqueotomia está indicada em condições com obstrução respiratória alta ou doença pulmonar obstrutiva crônica. As válvulas fonatórias (VF) de traqueotomia já foram anteriormente descritas, porém apresentam alto custo para o paciente, pois são todas importadas. Objetivo: Demonstrar a VF, desenvolvida na Universidade Estadual de Campinas, confeccionada em aço inox, para cânula de traqueotomia e a possibilidade de sua utilização na reabilitação fonatória desses pacientes. Forma de estudo: Clínico prospectivo. Material e Método: A VF, desenvolvida na Universidade Estadual de Campinas, foi utilizada em dez pacientes consecutivos. A válvula tem diafragma dentro de um corpo em aço inox com encaixes de plástico. Ela permite o direcionamento do ar para a laringe durante a fonação com oclusão do traqueotoma e abertura do mesmo na inspiração, sob baixa pressão. Resultados: Atualmente dez pacientes estão utilizando estas VF com fonação sem necessidade de oclusão do orifício externo da cânula e confortavelmente, inclusive durante o sono. Discussão: As VF para cânulas de traqueotomia melhoram a comunicação, inteligibilidade, higienização e umidificação das vias aéreas dos pacientes traqueotomizados. Há também melhora no aspecto emocional e diminuição das secreções orais e traqueais. O custo de produção dessa VF nacional é baixo e milhares de pacientes poderão ser beneficiados no Brasil. As crianças com traqueotomia podem apresentar retardo no desenvolvimento da linguagem. O uso da VF facilitará a comunicação e a interação social dessas crianças. Conclusão: A válvula fonatória metálica, desenvolvida na Universidade Estadual de Campinas, acoplada a uma cânula de traqueotomia metálica permite fonação, sem a oclusão digital da cânula, e respiração sob conforto.

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“…There are inconsistencies reported as to the effect a TT has on swallowing physiology [153][154][155][156][157][158][159][160][161][162][163]. By restoring the airflow through the upper airway, return of subglottic pressure during swallowing is facilitated [164].…”

Section: Swallowingmentioning

confidence: 99%

Towards an improved understanding of the effect of a speaking valve on lung volumes and communication in the critically ill tracheostomised patient

Sutt¹

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Tracheostomised mechanically ventilated patients are often left unable to speak, which is frustrating for patients and the staff caring for them. Having no voice causes major distress and feelings of helplessness for patients. Voicelessness frequently leads to reduced information exchange between the patient and healthcare team, frequently to the detriment of patient care. An in-line speaking valve (SV) is a one-way valve that may be used in the mechanical ventilation circuit to enable verbal communication in tracheostomised patients.Limited data exist regarding the effect of SVs on respiratory mechanics. Deflation of the tracheostomy cuff is required for placement of the SV, effectively causing a "leak" in the As an experienced speech pathologist, I believe concerns over SV use to date have little evidence. The main objective, and first aim of this thesis was to investigate the effect of SV use on respiratory mechanics to determine whether SVs should be used in-line with mechanical ventilation of tracheostomised patients. The second aim was to assess the effect of introducing SVs into a cardio-thoracic ICU on patient tracheostomy specific outcomes. The third aim was to further clarify the effect of SVs on success with healthrelated communication for ICU patients. To achieve these aims, 5 studies were conducted, resulting in 5 manuscripts.For the first aim, 20 tracheostomised ICU patients using a SV that met the inclusion criteria were recruited to the study from November 2013-December 2014. Electrical Impedance iii Tomography (EIT) was used to assess the patients' end-expiratory lung impedance (EELI) and ventilation distribution continuously over 60 minutes (before, during and after SV use). For the third aim, 25 patients and 52 nursing staff were asked to fill out a custom-made questionnaire on success with health communication, firstly when the patients were voiceless, and, secondly, when they were using a SV. Chapter 7 highlights individual differences and some disparity between patient and nursing ratings of communication success. Overall, however, following SV use both the patients and nursing staff reported a significant improvement in success with health communication. Additional variables included oxygenation (SpOIn conclusion, the findings of this thesis addressed the research aims, and provide new knowledge through use of an innovative approach to assessing lung mechanics. Having iv already resulted in real clinical changes in our centre, the results indicate the potential for optimising communication, using SVs in tracheostomised cardiothoracic ICU patients undergoing weaning from mechanical ventilation.v

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Effect of a One-Way Tracheotomy Speaking Valve on the Incidence of Aspiration in Previously Aspirating Patients with Tracheotomy

Cited by 60 publications

References 33 publications

Válvula fonatória brasileira para traqueotomia: padronização de pressão de diafragma

Válvula fonatória brasileira para traqueotomia: padronização de pressão de diafragma

Nova válvula fonatória para traqueotomia: uma proposta brasileira

Towards an improved understanding of the effect of a speaking valve on lung volumes and communication in the critically ill tracheostomised patient

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