Clinical utility and future direction of speaking valve: A review

Lian, S N; Teng, Liying; Mao, Zhi; Jiang, Hongying

doi:10.3389/fsurg.2022.913147

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…The benefits of SVs have been demonstrated in previous studies (2,17). EIT stands out as a valuable bedside tool for exploring the physiological impacts of SV (6,7).…”

Section: Discussionmentioning

confidence: 88%

Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study

Zhang,

Li,

et al. 2024

Preprint

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Objective: The aim of this study was to assess the impact of speaking valve (SV) on ventilation changes, spontaneous effort and their potential effectiveness in difficult-to-decannulate patients with diverse medical conditions. Methods:Patients with prolonged tracheostomy were included, who had been weaned from a ventilator for more than 48 hours, clinically stable and tolerance to the SV. Wearing time of the SV was extended continuously for 4 hours. Electrical impedance tomography (EIT) measurements were conducted at three time points: Tbaseline: prior to the SVs wearing; TSV ~ 3.5 hours after wearing the SVs; Tpost: 10 minutes after removal of SVs after a 4-hour SVs usage. Results: A total of 102 patients were included for the final analysis. No adverse event was recorded in ECG. Oxygenation and respiratory rate were stable. Ventilation distribution was homogeneous in some patients but not in the other after 3.5 hours SV training. Ventilation distributed towards dorsal regions during SV (p<0.001). As spontaneous effort increased during SV, EIT-derived pendelluft increased in most of the patients as well (p<0.001). The correlations between the days to decannulation and the change of EIT-based parameters were significantly correlated (p<0.001). The highest correlations were between Days and temporal ventilation heterogeneity indices (r=0.61 and 0.57, intra-tidal gas distribution and pendelluft, respectively, p<0.001). Conclusion: SV activated patients’ respiratory muscles by increasing the ventilation distribution portions in the dorsal regions, as well as introducing the temporal heterogeneity between ventral and dorsal regions. Such heterogeneity was associated with the day to decannulation.

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“…The benefits of SVs have been demonstrated in previous studies (2,17). EIT stands out as a valuable bedside tool for exploring the physiological impacts of SV (6,7).…”

Section: Discussionmentioning

confidence: 88%

Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study

Zhang,

Li,

et al. 2024

Preprint

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“…In our study, we deflated the cuff, and the patients wore the speaking valve to allow measurement of the CF SV from the mouth. We consider it a normal cough process facilitated by a speaking valve [ 30 ]; the CF SV was higher than that in Linda’s study [ 27 ]. In their study, the optimal cutoff value for predicting successful decannulation was only 29 L/min, but the patients were a neurosurgical cohort whose cough strength was influenced by neurological status.…”

Section: Discussionmentioning

confidence: 99%

Cough flows as a criterion for decannulation of autonomously breathing patients with tracheostomy tubes

Ge,

Niu,

et al. 2024

Respir Res

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Background Adequate cough or exsufflation flow can indicate an option for safe tracheostomy decannulation to noninvasive management. Cough peak flow via the upper airways with the tube capped is an outcome predictor for decannulation readiness in patients with neuromuscular impairment. However, this threshold value is typically measured with tracheotomy tube removed, which is not acceptable culturally in China. The aim of this study was to assess the feasibility and safety of using cough flow measured with tracheostomy tube and speaking valve (CFSV) > 100 L/min as a cutoff value for decannulation. Study design Prospective observational study conducted between January 2019 and September 2022 in a tertiary rehabilitation hospital. Methods Patients with prolonged tracheostomy tube placement were referred for screening. Each patient was assessed using a standardized tracheostomy decannulation protocol, in which CFSV greater than 100 L/min indicated that the patients’ cough ability was sufficient for decannulation. Patients whose CFSV matched the threshold value and other protocol criteria were decannulated, and the reintubation and mortality rates were followed-up for 6 months. Results A total of 218 patients were screened and 193 patients were included. A total of 105 patients underwent decannulation, 103 patients were decannulated successfully, and 2 patients decannulated failure, required reinsertion of the tracheostomy tube within 48 h (failure rate 1.9%). Three patients required reinsertion or translaryngeal intubation within 6 months. Conclusions CFSV greater than 100 L/min could be a reliable threshold value for successful decannulation in patients with various primary diseases with a tracheostomy tube. Trial registration This observational study was not registered online.

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“…The air then flows through the vocal cords and out of the nose and mouth, restoring airflow to the upper airway, improving throat sensation, re-establishing the glottic closure reflex and cough reflex, restoring intra-pharyngeal pressure, lowering the risk of aspiration and leakage, and allowing the patient to regain swallowing, vocalization, and speech functions. 15 Voice-related quality of life (V-RQOL) is a 10-item assessment designed, and validated for individuals with voice abnormalities to assess the social-emotional and physicalfunctional elements of voice difficulties. Pandian et al 5 examined patients' V-RQOL before and after a one-way speaking valve cannula intervention.…”

Section: Discussionmentioning

confidence: 99%

Comparing Voice Related Quality of Life scores between fenestrated and speaking valve cannula users

Yanti,

Dewi,

Bahar

2024

Oto Rhino Laryn Indones

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Background: Tracheostomy is a procedure that aims to maintain the airway so that air can enter the lungs and bypass the upper airway. Tracheostomy causes physiological changes, especially in terms of communication, which leads to reduced voice-related quality of life. Fenestrated tracheal cannula and speaking valve can assist patients in generating voice. Objective: To compare the V-RQOL scores of the fenestrated tracheal cannula and speaking valve users. Methods: Analytic observational study using a cross-sectional design. Data collection was done through interviews with the V-RQOL questionnaire guide. The study was conducted in September-December 2022 at the THTBKL Polyclinic of Dr. Mohammad Hoesin Hospital Palembang. Data were analyzed with IBM SPSS 26. Results: 42 patients were using tracheal cannula, with 21 patients each with a fenestrated and speaking valve tracheal cannula. Patients with fenestrated tracheal cannula had lower quality of life in the physical, social, and total domains than those in the speaking valve group (poor QoL in the physical domain: 66.67% vs. 9.52%; social domain: 85.71% vs. 57.14%; total domain: 76.19% vs. 4.76%; p<0.001). From the multivariate analysis, the tracheal cannula type influenced the patient's quality of life was (p<0.001). The probability of someone with a fenestrated tracheal cannula will experience a poor QoL is 76.2%, while speaking valve is 4.7%. Conclusion: The quality of life of patients with a fenestrated type of tracheal cannula is significantly lower than that of speaking valve tracheal cannula users in both the physical, social, and total domains as measured by the V-RQOL.

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Clinical utility and future direction of speaking valve: A review

Cited by 9 publications

References 29 publications

Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study

Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study

Cough flows as a criterion for decannulation of autonomously breathing patients with tracheostomy tubes

Comparing Voice Related Quality of Life scores between fenestrated and speaking valve cannula users

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