Optimizing Communication in Mechanically Ventilated Patients.

Autor:	Pandian V; Percutaneous Tracheostomy Service, The Johns Hopkins Hospital, Baltimore, MD., Smith CP; Speech-Language Pathology, The Johns Hopkins Hospital, Baltimore, MD., Cole TK; Speech-Language Pathology, The Johns Hopkins Hospital, Baltimore, MD., Bhatti NI; Otolaryngology Head-Neck Surgery, The Johns Hopkins Hospital, Baltimore, MD., Mirski MA; Anesthesia Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD., Yarmus LB; Interventional Pulmonary, The Johns Hopkins Hospital, Baltimore, MD., Feller-Kopman DJ; Interventional Pulmonary, The Johns Hopkins Hospital, Baltimore, MD.
Jazyk:	angličtina
Zdroj:	Journal of medical speech-language pathology [J Med Speech Lang Pathol] 2014; Vol. 21 (4), pp. 309-318.
Abstrakt:	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.
Databáze:	MEDLINE
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