Vinciya Pandian1, Christine P Smith2, Therese Kling Cole2, Nasir I Bhatti3, Marek A Mirski4, Lonny B Yarmus5, David J Feller-Kopman5. 1. Percutaneous Tracheostomy Service, The Johns Hopkins Hospital, Baltimore, MD. 2. Speech-Language Pathology, The Johns Hopkins Hospital, Baltimore, MD. 3. Otolaryngology Head-Neck Surgery, The Johns Hopkins Hospital, Baltimore, MD. 4. Anesthesia Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD. 5. Interventional Pulmonary, The Johns Hopkins Hospital, Baltimore, MD.
Abstract
PURPOSE: To describe the types of talking tracheostomy tubes available, present four case studies of critically ill patients who used a specialized tracheostomy tube to improve speech, discuss their advantages and disadvantages, propose patient selection criteria, and provide practical recommendations for medical care providers. METHODS: Retrospective chart review of patients who underwent tracheostomy in 2010. RESULTS: Of the 220 patients who received a tracheostomy in 2010, 164 (74.55%) received a percutaneous tracheostomy and 56 (25.45%) received an open tracheostomy. Among the percutaneous tracheostomy patients, speech-language pathologists were consulted on 113 patients, 74 of whom were on a ventilator. Four of these 74 patients received a talking tracheostomy tube, and all four were able to speak successfully while on the mechanical ventilator even though they were unable to tolerate cuff deflation. CONCLUSIONS: Talking tracheostomy tubes allow patients who are unable to tolerate-cuff deflation to achieve phonation. Our experience with talking tracheostomy tubes suggests that clinicians should consider their use for patients who cannot tolerate cuff deflation.
PURPOSE: To describe the types of talking tracheostomy tubes available, present four case studies of critically illpatients who used a specialized tracheostomy tube to improve speech, discuss their advantages and disadvantages, propose patient selection criteria, and provide practical recommendations for medical care providers. METHODS: Retrospective chart review of patients who underwent tracheostomy in 2010. RESULTS: Of the 220 patients who received a tracheostomy in 2010, 164 (74.55%) received a percutaneous tracheostomy and 56 (25.45%) received an open tracheostomy. Among the percutaneous tracheostomy patients, speech-language pathologists were consulted on 113 patients, 74 of whom were on a ventilator. Four of these 74 patients received a talking tracheostomy tube, and all four were able to speak successfully while on the mechanical ventilator even though they were unable to tolerate cuff deflation. CONCLUSIONS:Talking tracheostomy tubes allowpatients who are unable to tolerate-cuff deflation to achieve phonation. Our experience with talking tracheostomy tubes suggests that clinicians should consider their use for patients who cannot tolerate cuff deflation.
Entities:
Keywords:
and quality of life; communication; mechanically ventilation; speech; talking tracheostomy tube
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