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Randomized Controlled Trial
. 2020 May;130(5):1249-1255.
doi: 10.1002/lary.28211. Epub 2019 Aug 6.

Voice-Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial

Vinciya Pandian  1 , Therese Cole  2 , Dana Kilonsky  2 , Kate Holden  2 , David J Feller-Kopman  2 , Roy Brower  2 , Marek Mirski  2
Affiliations
Randomized Controlled Trial

Voice-Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial

Vinciya Pandian et al. Laryngoscope. 2020 May.

Abstract

Objective: The primary objective of our study was to determine the quality of life (QOL) using a talking tracheostomy tube.

Methods: Randomized clinical trial (NCT2018562). Adult intensive care unit patients who were mechanically ventilated, awake, alert, attempting to communicate, English-speaking, and could not tolerate one-way speaking valve were included. Intervention comprised a Blue Line Ultra Suctionaid (BLUSA) talking tracheostomy tube (Smiths Medical, Dublin, OH, US). Outcome measures included QOL scores measured using Quality of Life in Mechanically Ventilated Patients (QOL-MV) and Voice-Related Quality of Life (V-RQOL), Speech Intelligibility Test (SIT) scores, independence, and satisfaction.

Results: The change in V-RQOL scores from pre- to postintervention was higher among patients using a BLUSA (Smiths Medical) compared to those who did not (P = 0.001). The QOL-MV scores from pre- to postintervention were significantly higher among patients who used a BLUSA (Smiths Medical) compared to patients who did not use BLUSA (Smiths Medical) or a one-way speaking valve (P = 0.04). SIT scores decreased by 6.4 points for each 1-point increase in their Sequential Organ Failure Assessment scores (P = 0.04). The overall QOL-MV scores correlated moderately with the overall V-RQOL scores (correlation coefficient = 0.59). Cronbach alpha score for overall QOL-MV was 0.71. Seventy-three percent of the 22 intervention patients reported the ability to use the BLUSA (Smiths Medical) with some level of independence, whereas 41% reported some level of satisfaction with the use of BLUSA (Smiths Medical). The lengths of stay was longer in the intervention group.

Conclusion: Our study suggests that BLUSA (Smiths Medical) talking tracheostomy tube improves patient-reported QOL in mechanically ventilated patients with a tracheostomy who cannot tolerate cuff deflation.

Level of evidence: I Laryngoscope, 130:1249-1255, 2020.

Trial registration: ClinicalTrials.gov NCT02018562.

Keywords: Voice; critically ill; mechanical ventilation; quality of life; tracheostomy.

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References

BIBLIOGRAPHY

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