Effect of a Tracheostomy Speaking Valve on Secretions, Arterial Oxygenation, and Olfaction: A Quantitative Evaluation Tracheostomy speaking valves consist of a one-way valve that closes upon exhalation, causing a redirection of exhaled gas into the upper airway, thus allowing for the primary benefit of speech. the present study was undertaken to test various hypotheses concerning the secondary benefits of speaking valves. We hypothesized that use ... Research Article
Research Article  |   June 01, 1995
Effect of a Tracheostomy Speaking Valve on Secretions, Arterial Oxygenation, and Olfaction: A Quantitative Evaluation
 
Author Affiliations & Notes
  • Steven W. Lichtman
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
    Department of Medicine, College of Physicians and Surgeons, Columbia University New York, NY
  • Ingrid L. Birnbaum
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
  • Maria R. Sanfilippo
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
  • John T. Pellicone
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
    Department of Medicine, College of Physicians and Surgeons, Columbia University New York, NY
  • William J. Damon
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
    Department of Medicine, College of Physicians and Surgeons, Columbia University New York, NY
  • Marjorie L. King
    Department of Internal Medicine, Helen Hayes Hospital, West Haverstraw, NY
    Department of Medicine, College of Physicians and Surgeons, Columbia University New York, NY
  • Contact author: Steven W. Lichtman, EdD, Helen Hayes Hospital, Department of Internal Medicine, Route 9W, West Haverstraw, NY 10993.
    Contact author: Steven W. Lichtman, EdD, Helen Hayes Hospital, Department of Internal Medicine, Route 9W, West Haverstraw, NY 10993.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Speech / Research Articles
Research Article   |   June 01, 1995
Effect of a Tracheostomy Speaking Valve on Secretions, Arterial Oxygenation, and Olfaction: A Quantitative Evaluation
Journal of Speech, Language, and Hearing Research, June 1995, Vol. 38, 549-555. doi:10.1044/jshr.3803.549
History: Received August 1, 1994 , Accepted November 28, 1994
 
Journal of Speech, Language, and Hearing Research, June 1995, Vol. 38, 549-555. doi:10.1044/jshr.3803.549
History: Received August 1, 1994; Accepted November 28, 1994

Tracheostomy speaking valves consist of a one-way valve that closes upon exhalation, causing a redirection of exhaled gas into the upper airway, thus allowing for the primary benefit of speech. the present study was undertaken to test various hypotheses concerning the secondary benefits of speaking valves. We hypothesized that use of a speaking valve will result in a decrease in accumulated secretions, an increase in arterial oxygenation and an improvement in olfactory function. A total of 8 tracheotomized patients met the following inclusion criteria: age >18; ability to tolerate wearing a speaking valve for at least 3 hours; no unstable medical conditions; no use ,pf thrombolytic agents. While using the speaking valve patients accumulated fewer secretions (74.3 ± 63.6 vs. 122.8 ± 44.6 ml/day, p = 0.004, n = 7) and had improved olfactory function (accuracy = 28.4 ± 5.2 vs. 8.1 ± 2.9%, p = 0.02; and percent correct = 64.2 ± 2.6 vs. 50.0 ± 3.9%, p = 0.03, n = 6) than when off the speaking valve. No significant differences were found in 24-hour arterial oxygen saturation (pulse oximetry and ABG analysis respectively, n = 7), arterial PO2, pH, PCO2, HCO3, or 24-hour heart rate (n = 7). Thus, the present study found a significant decrease in secretions and improvements in olfaction when tracheotomized patients wore a speaking valve, but no difference in arterial oxygenation.

Acknowledgments
We are indebted to J.P. King, A.N. Gilbert, and S. Kemp (Givau-dan-Roure, Teaneck, NJ) and J. Corwin (NYU School of Medicine, NY), for their invaluable help in designing the olfactory testing, and to the Respiratory Care and Nursing Departments at Helen Hayes Hospital for their assistance in data collection.
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