Using ventilators for speaking and swallowing

Tippett, Donna C.; Siebens, Arthur A.

doi:10.1007/bf02493486

Cited by 24 publications

(10 citation statements)

References 18 publications

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“…Several approaches to eliminating or reducing aspiration in this patient population have been discussed in the literature. Some have reported that deflating the tracheostomy cuff improves swallow function [13]. To date, no research has examined the effect of cuff deflation on specific aspects of swallowing physiology, such as hyolaryngeal excursion or cricopharyngeal opening.…”

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confidence: 99%

Effects of Cuff Deflation and One-Way Tracheostomy Speaking Valve Placement on Swallow Physiology

2003

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This study examined the effects of tracheostomy cuff deflation and one-way speaking valve placement on swallow physiology. Fourteen nonventilator-dependent patients completed videofluoroscopic swallow studies (VFSS) under three conditions: (1) cuff inflated, (2) cuff deflated, and (3) one-way valve in place. Four additional patients with cuffless tracheostomy tubes completed VFSS with and without the one-way valve in place. All swallows were analyzed for the severity of penetration/aspiration using an 8-point penetration-aspiration scale. Seven preselected swallow duration measures, extent of hyolaryngeal elevation and anterior excursion, and oropharyngeal residue were also determined. Scores on the penetration-aspiration scale were not significantly affected by cuff status, i.e., inflation or deflation. However, one-way valve placement significantly reduced scores on the penetration-aspiration scale for the liquid bolus. Patients who are unable to tolerate thin liquids may be able to safely take thin liquids when the valve is in place. However, one-way valve placement may not be beneficial for all patients. Clinicians who complete VFSS with tracheostomized patients should include several bolus presentations with a one-way speaking valve in place before making any decisions regarding the use of the valve as a means to reduce aspiration.

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confidence: 99%

Effects of Cuff Deflation and One-Way Tracheostomy Speaking Valve Placement on Swallow Physiology

2003

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“…Some have suggested that the presence of an inflated tracheotomy tube cuff adversely affects swallowing. 13,23,24 Although not supported by empirical data, an inflated cuff was conjectured to either tether the larynx and reduce hyolaryngeal excursion and airway closure during the swallow or impinge on the tracheoesophageal wall and impede the passage of food or liquid through the esophagus. 6,13 Tippett and Siebens 24 examined the effects of tracheotomy tube cuff deflation on swallowing in 5 ventilator-dependent individuals, aged 21 to 70 years.…”

Section: Cuff Deflation and Swallowingmentioning

confidence: 97%

Contribution of Tracheotomy Tubes and One-way Speaking Valves to Swallowing Success

Suiter

Leder

2007

Topics in Geriatric Rehabilitation

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The contribution, if any, of a tracheotomy tube on aspiration status and swallowing success is investigated. Specific topics discussed include presence of a tracheotomy tube, tracheotomy tube cuff status, tracheotomy tube occlusion status, one-way tracheotomy tube speaking valves, and ventilator dependency. A critical analysis on the role of aging revealed that the high incidence of aspiration in older individuals with tracheotomies can be attributed to the critical illness that necessitated the tracheotomy tube in the first place rather than the tracheotomy tube per se, that is, trauma, severe pulmonary disease, altered mental status, and the use of medications to treat the critically ill. Speaking valves may improve swallow function for some but not all individuals and for some bolus types (thin liquids) but not others (puree consistency). Overall recommendations and suggestions for further research are discussed.

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“…Ventilation can be adequately maintained during cuff deflation in most individuals, despite some leakage of air through the larynx during inspiration. [68][69][70] Initially, to build tolerance for cuff deflation, it may be helpful to adjust ventilator settings such as tidal volume and to learn to volitionally close the glottis as needed to direct all inspired air to the lungs. By having the cuff partially or fully deflated, it is possible to produce "leak speech" by allowing a small amount of air to reach the vocal folds.…”

Section: Invasive Ventilationmentioning

confidence: 99%

Dysarthria of Spinal Cord Injury and Its Management

2017

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The dysarthria associated with spinal cord injury (SCI) is characterized by speech impairments that reflect respiratory dysfunction and its downstream effects on phonation, articulation, and prosody. The exact nature of the dysarthria is determined in large part by the level of SCI and whether or not diaphragm function is spared. Individuals with insufficient diaphragm strength to breathe on their own must rely on ventilator support, which may help or hinder speech, depending on a variety of ventilator-related variables. This article provides a conceptual review of the underlying pathophysiology and effects of respiratory muscle weakness on speech produced with and without mechanical ventilation. Selected multidisciplinary interventions for the dysarthria of SCI are also reviewed.

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Using ventilators for speaking and swallowing

Cited by 24 publications

References 18 publications

Effects of Cuff Deflation and One-Way Tracheostomy Speaking Valve Placement on Swallow Physiology

Effects of Cuff Deflation and One-Way Tracheostomy Speaking Valve Placement on Swallow Physiology

Contribution of Tracheotomy Tubes and One-way Speaking Valves to Swallowing Success

Dysarthria of Spinal Cord Injury and Its Management

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