A prospective evaluation of speaking tracheostomy tubes for ventilator dependent patients.

The effectiveness of speaking tracheostomy tubes for ventilator dependent patients has not been clearly established. Only a few reports by authors using the device are available. We describe our experience with 23 patients who were evaluated for insertion of the speaking tracheostomy tube. Nineteen patients were determined to be appropriate candidates and we observed significant benefits from its use in 15 of these patients. The major problems were air leaks around the cuff, nonavailability of smaller sizes, and dependence on an assistant during its use. Careful screening is important when selecting candidates for the device since inappropriate selection may cause further frustration and a sense of failure for the patient.