title: The use of tracheostomy speaking valves in mechanically ventilated patients results in improved communication and does not prolong ventilation time in cardiothoracic intensive care unit patients.
abstract: OBJECTIVE
  The aim of this study was to assess the effect of the introduction of in-line tracheostomy speaking valves (SVs) on duration of mechanical ventilation and time to verbal communication in patients requiring tracheostomy for prolonged mechanical ventilation in a predominantly cardiothoracic intensive care unit (ICU).
  
  
  METHODS
  We performed a retrospective preobservational-postobservational study using data from the ICU clinical information system and medical record. Extracted data included demographics, diagnoses and disease severity, mechanical ventilation requirements, and details on verbal communication and oral intake.
  
  
  RESULTS
  Data were collected on 129 patients. Mean age was 59 ± 16 years, with 75% male. Demographics, case mix, and median time from intubation to tracheostomy (6 days preimplementation-postimplementation) were unchanged between timepoints. A significant decrease in time from tracheostomy to establishing verbal communication was observed (18 days preimplementation and 9 days postimplementation, P <.05). There was no difference in length of mechanical ventilation (20 days preimplementation-post) or time to decannulation (14 days preimplementation-postimplementation). No adverse events were documented in relation to the introduction of in-line SVs.
  
  
  CONCLUSIONS
  In-line SVs were successfully implemented in mechanically ventilated tracheostomized patient population. This resulted in earlier verbal communication, no detrimental effect on ventilator weaning times, and no change in decannulation times.
  
  
  OBJECTIVE
  The purpose of the study was to compare tracheostomy outcomes in mechanically ventilated patients in a cardiothoracic ICU preintroduction and postintroduction of in-line SVs. It was hypothesized that in-line SVs would improve communication and swallowing specific outcomes with no increase in average time to decannulation or the number of adverse events.
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia. Electronic address: anna-liisa.sutt@health.qld.gov.au.
authors.forename: Anna-Liisa
authors.initials: AL
authors.lastname: Sutt
authors.affiliation: Behavioural Basis of Health, Griffith Health Institute, Griffith University, Mt Gravatt, Australia; Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia.
authors.forename: Petrea
authors.initials: P
authors.lastname: Cornwell
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mullany
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: Toni
authors.initials: T
authors.lastname: Kinneally
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
mesh_terms: D000368:Aged; D003142:Communication; D003325:Coronary Care Units; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods; D012189:Retrospective Studies; D013060:Speech; D013997:Time Factors; D014139:Tracheostomy / Q000379:methods*; D015300:Ventilator Weaning
keywords: Communication; Intensive care; Speaking valve; Speech pathology; Tracheostomy