Voice intensity of patients using a communi‐trach I<sup>®</sup> cuffed speaking tracheostomy tube

Leder, Steven B.; Traquina, Diana N.

doi:10.1288/00005537-198907000-00016

Cited by 21 publications

(36 citation statements)

References 4 publications

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“…The specialized talking tracheostomy tubes can be a solution for tracheostomized patient who cannot tolerate cuff deflation. The Portex Trach-Talk was successfully used in four studies, [ 36 , 38 , 39 , 42 ]; however, in another publication by Leder and Astrachan (1989) [ 56 ] stomal complications were reported in the form of pressure necrosis and wound extensions at the insertion of the airflow line. The more recently developed Portex BLUSA and the Blom Tracheostomy Tube appear to achieve sustained audible phonation [ 37 , 40 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

et al. 2016

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BackgroundVentilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently used in ICU patients. We summarized the current evidence on communication methods with mechanically ventilated patients in the ICU. Secondly, we developed an algorithm for communication with these patients based on current evidence.MethodsWe performed a systematic review. PubMed, Embase, Cochrane, Cinahl, PsychInfo, and Web of Science databases were systematically searched to November 2015. Studies that reported a communication intervention with conscious nonverbal mechanically ventilated patients in the ICU aged 18 years or older were included. The methodological quality was assessed using the Quality Assessment Tool.ResultsThe search yielded 9883 publications, of which 31 articles, representing 29 different studies, fulfilled the inclusion criteria. The overall methodological quality varied from poor to moderate. We identified four communication intervention types: (1) communication boards were studied in three studies—they improved communication and increased patient satisfaction, but they can be time-consuming and limit the ability to produce novel utterances; (2) two types of specialized talking tracheostomy tubes were assessed in eight studies—audible voicing was achieved in the majority of patients (range 74–100 %), but more studies are needed to facilitate safe and effective use; (3) an electrolarynx improved communication in seven studies—its effectiveness was mainly demonstrated with tracheostomized patients; and (4) “high-tech” augmentative and alternative communication (AAC) devices in nine studies with diverse computerized AAC devices proved to be beneficial communication methods—two studies investigated multiple AAC interventions, and different control devices (e.g., touch-sensitive or eye/blink detection) can be used to ensure that physical limitations do not prevent use of the devices. We developed an algorithm for the assessment and selection of a communication intervention with nonverbal and conscious mechanically intubated patients in the ICU.ConclusionsAlthough evidence is limited, results suggest that most communication methods may be effective in improving patient–healthcare professional communication with mechanically ventilated patients. A combination of methods is advised. We developed an algorithm to standardize the approach for selection of communication techniques.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1483-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

et al. 2016

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“…Most of the included studies were non randomised, observational studies, of which three were prospective observational studies involving 50 patients, 6,12,13 six observational studies without further specification of design involving 90 patients, 8,9,14-17 and six case studies involving 16 patients. 7,[18][19][20][21][22] Two randomised controlled clinical trials (RCT) with 75 patients assessing QOL related to the effect of ACV on speech were also included (Table 1).…”

Section: Characteristics Of Sources Of Evidencementioning

confidence: 99%

Above cuff vocalisation (ACV): A scoping review

Petosic

Viravong

Martin

et al. 2020

Acta Anaesthesiol Scand

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Introduction Patients in intensive care frequently suffer from not being able to communicate verbally. The aim of this scoping review was to study the safety and effectiveness of the above cuff vocalisation (ACV) on speech and quality of life (QOL) in patients dependent on a cuffed tracheostomy. Methods A scoping review was conducted. The databases Ovid Medline, Cochrane Library, and Embase were systematically searched in May 2020. We included clinical studies with patients exposed to ACV where speech, QOL or safety issues were assessed. Results Overall, 17 studies were included, of which 15 were observational and 2 were randomised controlled trials. Totally, 231 patients were included. ACV enabled most of the included patients (115/131; 88%) to speak with an audible voice or whisper (moderate quality of evidence). Voice related QOL (V‐RQOL) and QOL in mechanically ventilated patients (QOL‐MV) improved from pre‐ to post‐ ACV compared to a control group not tolerating a one‐way speaking valve (P = .01 and P = .04, respectively) (very low quality of evidence). Several minor complications or problems were reported in 20/75 (27%) cases in addition to two serious adverse events: subcutaneous emphysema in one patient where the tracheostomy was dislodged and a distended trachea in another due to the misconnection of continuous gas to the cuff (low/ very low quality of evidence). Conclusion ACV facilitated communication in patients dependent on a cuffed tracheostomy and attempting to communicate. Quality of evidence in improved V‐RQOL and QOL‐MV was very low. Several minor complications and two serious adverse events were reported.

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“…Historically, use of fenestrated tracheotomy tubes resulted in granulation tissue formation due to the number, placement, and sharpness of the edges of the fenestra (Leder, 1990;Leder & Traquina, 1989). Therefore, non-fenestrated tracheotomy tubes were and continue to be used in the vast majority of patients.…”

Section: Fenestrated Versus Non-fenestrated Tracheotomy Tubesmentioning

confidence: 99%

Verbal communication with the Blom low profile and Passy-Muir one-way tracheotomy tube speaking valves

Adam

Srinet

Aronberg

et al. 2015

Journal of Communication Disorders

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Voice intensity of patients using a communi‐trach I^® cuffed speaking tracheostomy tube

Cited by 21 publications

References 4 publications

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Above cuff vocalisation (ACV): A scoping review

Verbal communication with the Blom low profile and Passy-Muir one-way tracheotomy tube speaking valves

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Voice intensity of patients using a communi‐trach I® cuffed speaking tracheostomy tube

Cited by 21 publications

References 4 publications

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Above cuff vocalisation (ACV): A scoping review

Verbal communication with the Blom low profile and Passy-Muir one-way tracheotomy tube speaking valves

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Product

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Voice intensity of patients using a communi‐trach I^® cuffed speaking tracheostomy tube