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Speaking valve tracheostomy

Charlotte Buswell, Jason Powell, Steven Powell
Paediatric tracheostomy can be a life saving procedure, but one with many unwanted effects, including a significant effect on phonation. This can range from reduced intensity and length of phonation to aphonia. This impairment has detrimental effects on a child's ability to express themselves, communicate with those around them, and ultimately may adversely impact on their speech and language development(1) . Rates of tracheostomy in children are increasing in many countries with improved healthcare(2) . This article is protected by copyright...
October 19, 2016: Clinical Otolaryngology
Maria Vargas, Giuseppe Servillo
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
Giselle Y Barraza, Claudia Fernandez, Claudia Halaby, Sara Ambrosio, Edwin F Simpser, Melodi B Pirzada, Shahidul Islam
No abstract text is available yet for this article.
September 2016: American Journal of Otolaryngology
Anna-Liisa Sutt, Lawrence R Caruana, Kimble R Dunster, Petrea L Cornwell, Chris M Anstey, John F Fraser
BACKGROUND: Patients who require positive pressure ventilation through a tracheostomy are unable to phonate due to the inflated tracheostomy cuff. Whilst a speaking valve (SV) can be used on a tracheostomy tube, its use in ventilated ICU patients has been inhibited by concerns regarding potential deleterious effects to recovering lungs. The objective of this study was to assess end expiratory lung impedance (EELI) and standard bedside respiratory parameters before, during and after SV use in tracheostomised patients weaning from mechanical ventilation...
2016: Critical Care: the Official Journal of the Critical Care Forum
Jennifer Lee, Marlene A Soma, Arthur Y Teng, Ganesh Thambipillay, Karen A Waters, Alan T Cheng
INTRODUCTION: Tracheostomy decannulation in the paediatric patient is usually considered when there is resolution or significant improvement in the original indication for the tracheostomy. The child's cardiorespiratory function needs to be optimized and assessment of the readiness for decannulation is generally by endoscopic evaluation to confirm airway patency and vocal cord mobility. Functional airway assessment procedures include downsizing the tracheostomy, adding fenestration, speaking valves and capping the tracheostomy tube...
April 2016: International Journal of Pediatric Otorhinolaryngology
Jennifer K Henningfeld, Kristyn Maletta, Bixiang Ren, Kathie L Richards, Carole Wegner, Lynn A D'Andrea
BACKGROUND: The prevalence of children requiring outpatient invasive long-term mechanical ventilation is increasing. For some children, liberation from home mechanical ventilation (HMV) and decannulation is the desired outcome. This study describes our experience liberating tracheostomy and HMV (T-HMV) dependent children from respiratory technologies. METHODS: We reviewed charts of T-HMV dependent children who were cared for at our institution and decannulated between July 1999 and December 2011...
August 2016: Pediatric Pulmonology
Amy L Freeman-Sanderson, Leanne Togher, Mark R Elkins, Paul R Phipps
OBJECTIVES: A cuffed tracheostomy tube facilitates prolonged mechanical ventilation and weaning but usually leads to prolonged voicelessness, which can be one of the most negative experiences of hospitalization. No randomized trials have examined the effects of targeted early communication intervention for the restoration of voice in ventilated tracheostomy patients in the ICU. DESIGN: A prospective randomized clinical trial. SETTING: The trial was conducted in the ICU of an urban tertiary level hospital...
June 2016: Critical Care Medicine
Amit Agarwal, Nancy Marks, Valerie Wessel, Denise Willis, Shasha Bai, Xinyu Tang, Wendy L Ward, Dennis E Schellhase, John L Carroll
OBJECTIVE: The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program...
July 2016: Pediatric Pulmonology
Alan H Shikani, Andrew C Miller, Elamin M Elamin
PURPOSE: Tracheostomy speaking valve use may increase airflow resistance and work of breathing. It remains unclear which valve offers the best performance characteristics. We compared the performance characteristics of the Shikani speaking valve (SSV; unidirectional-flow ball valve) with those of the Passy-Muir valve (PMV; bias-closed flapper valve). METHOD: Airflow resistance was measured for both the SSV and the PMV at 8 flow amplitudes and in 3 orientations (-15°, 0°, +20°) in the bias-open and bias-closed configurations...
November 2015: American Journal of Speech-language Pathology
Anna-Liisa Sutt, Petrea Cornwell, Daniel Mullany, Toni Kinneally, John F Fraser
PURPOSE: The aim of this study was to assess the effect of the introduction of in-line tracheostomy speaking valves (SVs) on duration of mechanical ventilation and time to verbal communication in patients requiring tracheostomy for prolonged mechanical ventilation in a predominantly cardiothoracic intensive care unit (ICU). MATERIALS AND METHODS: We performed a retrospective preobservational-postobservational study using data from the ICU clinical information system and medical record...
June 2015: Journal of Critical Care
Dean R Hess, Neila P Altobelli
Tracheostomy tubes are used to administer positive-pressure ventilation, to provide a patent airway, and to provide access to the lower respiratory tract for airway clearance. They are available in a variety of sizes and styles from several manufacturers. The dimensions of tracheostomy tubes are given by their inner diameter, outer diameter, length, and curvature. Differences in dimensions between tubes with the same inner diameter from different manufacturers are not commonly appreciated but may have important clinical implications...
June 2014: Respiratory Care
Giselle Y Barraza, Claudia Fernandez, Claudia Halaby, Sara Ambrosio, Edwin F Simpser, Melodi B Pirzada
PURPOSE: One of the disadvantages of having a tracheostomy tube is not being able to vocalize. A speaking valve connected to a tracheostomy tube allows patients to vocalize. Some studies have shown that tracheostomy-speaking valve can improve swallowing, respiratory secretion management, and expedite decannulation. There is scant research about speaking valve use during sleep. The aim of this study is to evaluate the safety of tracheostomy-speaking valve overnight, during sleep. MATERIALS AND METHODS: Children, ages 1-18 years, with tracheostomy tubes who were using a tracheostomy-speaking valve during daytime/awake periods, were included in this study...
September 2014: American Journal of Otolaryngology
John Schembri, Kelvin Cortis, Charles Mallia Azzopardi, Stephen Montefort
Foreign body aspiration (FBA) is a relatively common and serious condition that can result in a spectrum of presentations ranging from incidental to acutely life-threatening. Described here is a case of aspiration of a tracheo-oesophageal speaking valve through a permanent tracheostomy that went unnoticed for a number of years, and an overview of the technique used for its removal. A 70-year-old ex-heavy smoker with a permanent tracheo-oesophageal fistula presented with a relatively recent history of increasing shortness of breath, sputum purulence and haemoptysis...
2013: BMJ Case Reports
M Clarett, M F Andreu, I G Salvati, M C Donnianni, G S Montes, M G Rodríguez
OBJECTIVE: To determine whether there are differences between subglottic pressure during swallowing with and without air insufflation via a subglottic catheter in tracheostomized patients. DESIGN: A prospective, randomized cross-over study was made. SETTING: Adult Intensive Care Units. PARTICIPANTS: Patients requiring mechanical ventilation and tracheostomy with a subglottic catheter, and with tolerance to deflation of the balloon and a speaking valve placed over the opening of the tracheostomy tube...
April 2014: Medicina Intensiva
M I Akenroye, A T Osukoya
BACKGROUND: Upper respiratory tract obstruction resulting from bilateral recurrent laryngeal nerve damage is commonly managed with permanent tracheostomy in our environment. OBJECTIVE: To evaluate the social impacts of permanent tracheostomy and its management in Ondo State, Southwest Nigeria. MATERIALS AND METHODS: Four patients were managed with permanent tracheostomy due to bilateral laryngeal nerve paralysis following thyroidectomy. The observed complications are grouped as surgical/medical and social complications...
January 2013: Nigerian Journal of Clinical Practice
Lauren Speed, Katherine E Harding
PURPOSE: Multidisciplinary tracheostomy teams have been implemented in acute hospitals over the past 10 years. This systematic review of the literature and meta-analysis aimed to assess the effect of tracheostomy teams on patient outcomes. MATERIALS AND METHODS: We conducted an electronic search of the literature in the following databases: MEDLINE, CINAHL, EMBASE, and AMED. Inclusion/exclusion criteria were applied, and included articles were assessed against quality criteria...
April 2013: Journal of Critical Care
Daniel F Fisher, Dhimiter Kondili, June Williams, Dean R Hess, Edward A Bittner, Ulrich H Schmidt
BACKGROUND: Presence of a tracheostomy tube often decreases the patient's ability to communicate and to tolerate oral intake. The initial tracheostomy tube change is often recommended between day 7 and 14 post insertion. Local guidelines permit tracheostomy tube change 5 days after insertion. OBJECTIVE: We hypothesized that changing tracheostomy tubes before day 7 is associated with earlier use of a speaking valve as well as earlier oral intake, compared to changing tracheostomy tubes after 7 days...
February 2013: Respiratory Care
Alison Buckland, Lara Jackson, Toni Ilich, Jodi Lipscombe, Graeme Jones, Shyan Vijayasekaran
OBJECTIVES/HYPOTHESIS: Placement of a Passy-Muir speaking valve is considered best practice for infants and children with a tracheostomy. The Passy-Muir valve enables phonation by redirecting exhaled air via the glottis. Poor tolerance of the Passy-Muir valve is associated with excessive transtracheal pressures on exhalation due to upper airway obstruction. Drilling a small hole in the side of the Passy-Muir valve creates a pressure relief port to allow partial exhalation through the tracheostomy tube while enabling phonation...
October 2012: Laryngoscope
Eduard B van der Houwen, Tjouwke A van Kalkeren, Johannes G M Burgerhof, Bernard F A M van der Laan, Gijsbertus J Verkerke
OBJECTIVES: We performed in vitro evaluation of a novel, disposable, automatic hands-free tracheostoma speech valve for laryngectomy patients based upon the principle of inhalation. The commercially available automatic speech valves close upon strong exhalation and open again when the pressure drops. This method makes long sentences or pauses difficult. The novel iValve is designed to allow almost natural speech, with mid-sentence pausing and whispering. METHODS: The inhalation closing flows and exhalation opening pressures of 6 iValve prototype versions at different settings were compared with physiological values...
December 2011: Annals of Otology, Rhinology, and Laryngology
Hélène Prigent, Michèle Lejaille, Nicolas Terzi, Djillali Annane, Marjorie Figere, David Orlikowski, Frédéric Lofaso
PURPOSE: Expiratory flow towards the upper airway after swallowing serves to expel liquid or food particles misdirected towards the trachea during swallowing. However, expiration may not occur consistently after swallowing in tracheostomised patients with an open tracheostomy tube. We investigated the effect of a speaking valve (SV) on breathing-swallowing interactions and on the volume expelled through the upper airway after swallowing. METHODS: Eight tracheostomised neuromuscular patients who were able to breathe spontaneously were studied with and without an SV...
January 2012: Intensive Care Medicine
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