passy muir valve

OBJECTIVE: The study objective is to identify factors that impact the time to decannulation in pediatric patients ages 0 through 18 years who are tracheostomy-dependent. METHODS: This retrospective chart review from January 1, 2005 through December 31, 2020 identified pediatric tracheostomy patients at a single pediatric institution. Data extracted included demographic, socioeconomic factors, and clinical characteristics. Multivariate regression and survival analysis were used to identify factors associated with successful decannulation and decreased time with tracheostomy...

BACKGROUND: Pediatric tracheostomy decannulation protocols vary among institutions and may include toleration of Passy Muir Valve (PMV), microlaryngoscopy and bronchoscopy (MLB) findings, and polysomnography evaluation. Transtracheal pressure (TTP) is an objective measurement utilized to evaluate PMV toleration. We aimed to investigate the role of TTP in decannulation candidates and compare TTP measurements with polysomnography and MLB findings. METHODS: A retrospective cohort study of children who underwent TTP measurement during PMV trial between December 2012 and November 2022...

OBJECTIVE: Describe the tracheostomy and ventilation management of patients admitted due to COVID-19 as facilitated by speech language pathologists (SLPs) and otolaryngologists within the long-term acute care hospital (LTACH) setting. STUDY DESIGN: Retrospective cohort study. SETTING: Long-term acute care hospital. SUBJECTS AND METHODS: A retrospective chart review was conducted on all patients admitted to RML Specialty Hospital for respiratory failure secondary to COVID-19 from April 1, 2020 to November 30, 2021...

OBJECTIVE: Aspiration is a common complication after tracheostomy in patients with acquired brain injury (ABI), resulting from impaired swallowing function, and which may lead to aspiration pneumonia. The Passy-Muir Tracheostomy and Ventilator Swallowing and Speaking Valve (PMV) has been used to enable voice and reduce aspiration; however, its mechanism is unclear. This study aimed to investigate the mechanisms underlying the beneficial effects of PMV intervention on the prevention of aspiration...

BACKGROUND: One-way speaking valves were first engineered to improve communication in patients with tracheostomies. More recently, additional indications for one-way speaking valves have been explored, including improving ventilation, weaning, and reducing aspiration; however, safety and adverse events have not been well defined. OBJECTIVES: The aim of this study was to examine the cardiorespiratory changes that occur with prolonged use of a one-way speaking valve in relation to safety and efficacy...

OBJECTIVE: To assess the effect of Passy-Muir® Valve (PMV) tolerance on respiratory illness and respiratory related hospital admissions in tracheostomy-dependent children. METHODS: Retrospective cohort study of 262 patients who underwent tracheostomy placement between 2012 and 2018 at a tertiary free-standing children's hospital. Outcome measures studied were number of reported upper respiratory infections and respiratory related hospitalizations per year (RRH/year)...

Purpose Tracheostomy patients face many adversities including loss of phonation and essential airway functions including air filtering, warming, and humidification. Heat and moisture exchangers (HMEs) facilitate humidification and filtering of inspired air. The Shikani HME (S-HME) is a novel turbulent airflow HME that may be used in-line with the Shikani Speaking Valve (SSV), allowing for uniquely preserved phonation during humidification. The aims of this study were to (a) compare the airflow resistance ( R airflow ) and humidification efficiency of the S-HME and the Mallinckrodt Tracheolife II tracheostomy HME (M-HME) when dry (time zero) and wet (after 24 hr) and (b) determine if in-line application of the S-HME with a tracheostomy speaking valve significantly increases R airflow over a tracheostomy speaking valve alone (whether SSV or Passy Muir Valve [PMV])...

OBJECTIVE: The aim of this study was to investigate if there are predictors for success with Passy Muir Valve (PMV) placement for medically complex pediatric patients. METHODS: Retrospective chart review of 52 pediatric patients with a tracheostomy with or without ventilator dependence who received PMV assessments from October 2017 through October 2018 in intensive care units and acute care units within Children's Healthcare of Atlanta (Atlanta, GA). Univariate analysis and logistic regression modeling were used to identify factors associated with a successful PMV trial...

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The aim of this prospective, consecutive, cohort study was to investigate the biomechanical effects, if any, of the Blom low profile voice inner cannula and Passy-Muir one-way tracheotomy tube speaking valves on movement of the hyoid bone and larynx during swallowing. Ten adult patients (8 male, 2 female) with an age range of 61-89 years (mean 71 years) participated. Criteria for inclusion were ≥18 years of age, English speaking, and ability to tolerate both changing to a Blom tracheotomy tube and placement of a one-way tracheotomy tube speaking valve with a fully deflated tracheotomy tube cuff...

OBJECTIVE: To investigate physiologic parameters, voice production abilities, and functional verbal communication ratings of the Blom low profile voice inner cannula and Passy-Muir one-way tracheotomy tube speaking valves. STUDY DESIGN: Case series with planned data collection. SETTING: Large, urban, tertiary care teaching hospital. SUBJECTS AND METHODS: Referred sample of 30 consecutively enrolled adults requiring a tracheotomy tube and tested with Blom and Passy-Muir valves...

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...

OBJECTIVES/HYPOTHESIS: To report preliminary experience in the utilization of transoral robotic surgical (TORS) techniques in pediatric airway surgery. STUDY DESIGN: Retrospective case series. METHODS: A retrospective chart review was performed on all pediatric patients undergoing robotic airway surgery at a university-based children's hospital between August 2010 and December 2012. RESULTS: Three pediatric patients underwent robotic repair of various airway anomalies between August 2010 and December 2012...

OBJECTIVES/HYPOTHESIS: Alterations in swallowing can occur after tracheotomy and can result in varying degrees of aspiration. In tracheotomized adult patients, use of a Passy Muir Speaking Valve (PMV) has been shown to decrease laryngeal penetration and aspiration of foods and liquids. The objective of this study was to determine if the PMV has a similar effect on laryngeal penetration and aspiration in tracheotomized children. STUDY DESIGN: This is a prospective case-control study...

Dysphagia occurs in a significant number of individuals with spinal cord injury (SCI) presenting to acute care and inpatient rehabilitation. This prospective study has found dysphagia in nearly 40% of individuals with tetraplegia. Tracheostomy, mechanical ventilation, nasogastric tube, and age are significant risk factors. The detrimental complications of dysphagia in SCI can cause significant morbidity and delays in rehabilitation. Thus, early and accurate diagnosis of dysphagia is imperative to reduce the risk of developing life-threatening complications...

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...

OBJECTIVE: The aim of this study was to examine the relationship between cough peak flows (CPFs) before and after tracheostomy tube removal (decannulation) in patients with neuromuscular respiratory muscle weakness. DESIGN: For 26 patients with occluded tracheostomies (capped or Passy-Muir valve), spontaneous CPF (CPF(sp)), CPF after lung volume recruitment (CPF(LVR)), and CPF after lung volume recruitment and a manually assisted cough (CPF(LVR) + MAC) were measured before and after decannulation...

BACKGROUND: The objective of this work was to obtain a controlled subjective and objective in vivo clinical comparison of the Passy-Muir, Shiley, and Ball speaking valves. METHODS: Ten patients free of laryngeal pathology but dependent on tracheotomy for respiration were tested with each of the speaking valves. Olfaction was assessed for each patient using the University of Pennsylvania Smell Identification Test (UPSIT). Acoustic and perceptual analyses included subjective assessments, noninstrumental objective assessments (including maximum phonation time, and S:Z ratio), and instrumental objective assessments (including fundamental frequency:maximum phonation range, vocal intensity, perturbation, naturalness, and turbulence)...

Chimpanzee attacks can be vicious, mutilating, and disabling if not fatal. Stereotypically, the hands and face are targeted, and in male victims, genitalia are mutilated. The authors present a case highlighting the difficulties with early neurological assessment following such an attack. This 55-year-old woman was attacked by a 14-year-old chimpanzee. She suffered mutilation of both hands, severe midface bony, soft-tissue, and eye injuries, and scalp degloving. An emergency tracheotomy was performed at the scene, with an unclear duration of hypoxia...

PURPOSE: Many patients with respiratory failure related to neuromuscular disease receive chronic invasive ventilation through a tracheostomy. Improving quality of life, of which speech is an important component, is a major goal in these patients. We compared the effects on breathing and speech of low-level positive end-expiratory pressure (PEEP, 5 cmH(2)O) and of a Passy-Muir speaking valve (PMV) during assist-control ventilation. METHODS: We studied ten patients with neuromuscular disorders, between December 2008 and April 2009...