title: Optimizing Communication in Mechanically Ventilated Patients.
abstract: OBJECTIVE
  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.
authors.affiliation: Percutaneous Tracheostomy Service, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Vinciya
authors.initials: V
authors.lastname: Pandian
authors.affiliation: Speech-Language Pathology, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Christine P
authors.initials: CP
authors.lastname: Smith
authors.affiliation: Speech-Language Pathology, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Therese Kling
authors.initials: TK
authors.lastname: Cole
authors.affiliation: Otolaryngology Head-Neck Surgery, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Nasir I
authors.initials: NI
authors.lastname: Bhatti
authors.affiliation: Anesthesia Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Marek A
authors.initials: MA
authors.lastname: Mirski
authors.affiliation: Interventional Pulmonary, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Lonny B
authors.initials: LB
authors.lastname: Yarmus
authors.affiliation: Interventional Pulmonary, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: David J
authors.initials: DJ
authors.lastname: Feller-Kopman
keywords: and quality of life; communication; mechanically ventilation; speech; talking tracheostomy tube