Safety and feasibility of above cuff vocalisation for ventilator-dependant patients with tracheostomies

Journal of the Intensive Care Society
Brendan A McGrathAndrew M Bentley

Abstract

Temporary tracheostomy is commonly used in patients admitted to intensive care units. Cuffed tubes prevent laryngeal airflow, preventing vocalisation. Sub-glottic suction tubes such as the 'Blue Line Ultra Suctionaid™' are used primarily to remove sub-glottic secretions, but retrograde gas flows via the suction port can facilitate above cuff vocalisation. The aims were to assess whether patients could achieve an audible voice using above cuff vocalisation, to demonstrate the safe use of the Blue Line Ultra Suctionaid™ tracheostomy tube for above cuff vocalisation, and to assess potential benefits of above cuff vocalisation for communication, secretion management and swallowing. Our study (Reference 15/NW/0464, IRAS 178997) recruited adult intensive care unit patients who were alert, able to participate in an above cuff vocalisation trial and dependent on an inflated Blue Line Ultra Suctionaid™ cuff for ventilatory support. Consenting participants underwent fibreoptic endoscopic assessment of swallow by experienced Speech & Language Therapy staff with and without above cuff vocalisation. Clinical and fibreoptic endoscopic assessment of swallow, assessment of voice quality, swallowing and secretion management were recorded and sc...Continue Reading

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Citations

Jul 30, 2020·BMJ Open Respiratory Research·Kirsty A WhitmoreKevin B Laupland
Sep 14, 2020·Acta Anaesthesiologica Scandinavica·Antonija PetosicHelene Berntzen
Jun 29, 2021·BJA Education·S Wallace, B A McGrath

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