The Effect of a Speaking Valve on Laryngeal Aspiration and Penetration in Children With Tracheotomies

Ongkasuwan, Julina; Turk, Catherine L.; Rappazzo, Christina; Lavergne, Katherine A.; Smith, E. O’Brian; Friedman, Ellen M.

doi:10.1002/lary.24457

Cited by 23 publications

(22 citation statements)

References 26 publications

(65 reference statements)

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“…Ongkasuwan et al (2014) [19] Laryngeal aspiration and penetration was reduced in pureed consistencies compared with thin liquid, but there was no difference with or without the speaking valve. There was a decrease in piriform sinus residue with the presence of the speaking valve.…”

Section: Intervention Groupmentioning

confidence: 97%

“…Eight studies [12][13][14][15][16][17][18][19] included aspiration as an outcome measure, with 5 of those studies able to be analysed in a meta-analysis [12][13][14][15]20]. A random-effect model (I 2 =71.96, p=0.006) found reduced instances of aspiration with a speaking valve in situ, compared to without a speaking valve in situ (OR 0.122; 95% confidence interval, 0.031-0.479; P= 0.003) (figure 2).…”

Section: Aspirationmentioning

confidence: 99%

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Physiological and clinical outcomes associated with use of one-way speaking valves on tracheostomised patients: A systematic review

2019

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Background: The one-way speaking valve was first engineered in 1985 to allow patients with tracheostomy tubes to communicate. The research has indicated alternative physiological benefits of using a speaking valve, however this literature has not yet been evaluated. The purpose of this systematic review is to evaluate the evidence for the one-way speaking valve in relation to a range of physiological and clinical domains including vital signs, aspiration, olfaction, ventilation and tracheostomy weaning, hospital length of stay, and quality of life. Methods: A literature search was conducted in September 2017. Studies were eligible if they compared the use of a one-way speaking valve to no speaking valve in tracheostomised patients, across various physiological or clinical parameters. Results: Sixteen eligible studies were included in this review. A meta-analysis random-effect model (I 2 =71.96, p=0.006) found reduced instances of aspiration when a speaking valve was in situ compared to no speaking valve in situ (OR 0.122; 95% confidence interval, 0.031-0.479; P= 0.003). Statistically significant results were also found for the use of a one-way speaking valve in terms of olfaction, secretion management and ventilation. Conclusion: There is emerging evidence for the additional benefits of using one-way speaking valves in patients with tracheostomy tubes. Further studies are required to investigate these other promising utilities of the speaking valve and the subsequent effects on reducing healthcare costs and improving patient outcomes.

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Section: Intervention Groupmentioning

confidence: 97%

Section: Aspirationmentioning

confidence: 99%

Physiological and clinical outcomes associated with use of one-way speaking valves on tracheostomised patients: A systematic review

2019

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“…Five studies 4,[12][13][14]20 included a total of 33 children with a tracheostomy for mechanical ventilation. The remaining 5 studies 11,[17][18][19]21 included 162 children who had varied indications for tracheostomy. Specifically, 82 had a tracheostomy for upper-airway obstruction and laryngeal abnormalities, 54 required a tracheostomy for mechanical ventilation, and 26 children had a tracheostomy for pulmonary clearance (see Table 1).…”

Section: Characteristics and Level Of Evidence Of The Selected Studiesmentioning

confidence: 99%

“…Four studies 4,13,17,18 (33.3%) used speaking valve manufacturer indications as a general guide and reported additional inclusion/exclusion criteria. One study 19 (8.3%) did not report any inclusion/exclusion criteria. Supplementary Table 1 provides details on the inclusion criteria for speaking valve candidacy (see the supplementary table at http://www.rcjournal.com).…”

Section: Eligibility Criteria For Trials Of a Speaking Valvementioning

confidence: 99%

“…Ninety-three of 103 subjects from these studies tolerated the speaking valve if trialed. Five 14,15,18,19,21 (of a total of 10) studies reported tolerance and successful use of a speaking valve during awake hours as a secondary outcome but did not define tolerance or success. One study 20 (of a total of 10) reported safety of a speaking valve during sleep as a primary outcome, defined as stable vital signs and gas exchange (oxygen saturation and end-tidal CO 2 ) 1 night before trials of a speaking valve.…”

Section: Benefits Of Speaking Valve Usementioning

confidence: 99%

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The Use of Speaking Valves in Children With Tracheostomy Tubes

Zabih¹,

Holler

Syed³

et al. 2017

Respir Care

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One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making. The Arksey and O'Malley 5-step methodological framework was used for this scoping review. We searched OVID MEDLINE, EMBASE, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar to locate articles published between January 1, 1946 and May 26, 2016. Our search resulted in a total of 524 articles. After removing 270 duplicates, we screened 254 abstracts, and 50 articles were identified for full text review. We excluded 38 references. A total of 12 articles met our inclusion criteria. Details of all studies were charted. Application of the Sackett levels of evidence to evaluate the qualitative strength of the evidence provided by the 12 articles selected for study found that 6 studies were level 5, 4 were level 4, and 2 studies were categorized as level 3 evidence. Eligibility criteria for trials of speaking valves were inconsistent across all studies and included a combination of clinical assessment coupled with published indications. Much of the literature has focused on tolerance/successful use of speaking valves in children with a tracheostomy with limited evidence on its impact on verbal communication. Current evidence on the use of speaking valves in children with a tracheostomy, its indication, and its impact on verbal communication is inadequate, mandating further research in this area.

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Feeding Disorders in Children With Tracheostomy Tubes

et al. 2020

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Background We aimed to describe feeding dysfunction in a group of children with tracheostomy. Methods Single‐center, retrospective chart review of all children with a tracheostomy who were evaluated by our interdisciplinary feeding program. Demographic and diagnostic data, nutrition variables, acceptance of food consistencies, as well as 2 validated psychometric instruments for assessment of feeding dysfunction were analyzed. Results Thirteen tracheostomy‐dependent children (5/13; 38% ventilator dependent) were evaluated at a median age of 51 months (interquartile range [IQR], 26–69). The majority of children (8/13; 62%) underwent evaluation after decannulation. Four children (30%) had a history of a cuffed tracheostomy tube. Eleven children (85%) used a speaking valve prior to decannulation, only 2 of whom started before initial discharge with a tracheostomy. Children with a tracheostomy had low‐median weight‐ and height‐for‐age z‐scores (−1.27 and −1.73, respectively), with normal‐median body mass index (BMI)–for‐age z‐score (0.175). Children received 75% of feedings via tube feeding (IQR, 13%–97%). Compared with other children with feeding disorders, children with tracheostomy had delays in initial acceptance of most food textures and general diet, and the Mealtime Behavior Questionnaire showed significantly worse overall scores (P = .01), and the About Your Child's Eating survey showed significantly higher parental perception of resistance to eating (P = .0001). Conclusion Requirement of enteral nutrition, poor oral‐feeding skills, chronic malnutrition, and worse mealtime behaviors are associated with tracheostomy. A history of ventilator dependence, cuffed tracheostomy, and inpatient speaking valve–use were infrequently associated with interdisciplinary feeding‐program evaluation.

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The Effect of a Speaking Valve on Laryngeal Aspiration and Penetration in Children With Tracheotomies

Abstract: 3b.

Cited by 23 publications

References 26 publications

Physiological and clinical outcomes associated with use of one-way speaking valves on tracheostomised patients: A systematic review

Physiological and clinical outcomes associated with use of one-way speaking valves on tracheostomised patients: A systematic review

The Use of Speaking Valves in Children With Tracheostomy Tubes

Feeding Disorders in Children With Tracheostomy Tubes

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