RT Journal Article
SR Electronic
T1 The Effect of Speaking Valves on ICU Mobility of Individuals With Tracheostomy
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.06768
DO 10.4187/respcare.06768
A1 Camila Ceron
A1 Danielle Otto
A1 Alana Verza Signorini
A1 Marco Colomé Beck
A1 Marcio Camilis
A1 Daniel Sganzerla
A1 Régis Goulart Rosa
A1 Cassiano Teixeira
YR 2019
UL http://rc.rcjournal.com/content/early/2019/10/15/respcare.06768.abstract
AB BACKGROUND: Early mobilization is part of the rehabilitation process for critically ill patients and is currently considered a means of preventing ICU-acquired muscle deterioration and worsening of physical function. We sought to determine whether the use of speaking valves in tracheostomized patients would improve their mobility. We evaluated the changes in mobility performance with the use of speaking valves in tracheostomized subjects.METHODS: We performed a cohort study of a series of subjects who were tracheostomized and were being weaned from mechanical ventilation between April 2016 and May 2018. The subjects were those able to tolerate a speaking valve for a minimum of 30 min. Demographic data, comorbidities, cause of ICU admission, days in the ICU, duration of mechanical ventilation before tracheostomy, and days free from mechanical ventilation before tracheostomy were collected. Mobility status was evaluated using daily measurements of the Perme Intensive Care Unit Mobility Score.RESULTS: During the study period, 63 patients were tracheostomized. Patients with deficiencies in language (n = 2) or cognitive deficits (n = 36) and patients in exclusive palliative care (n = 7) were excluded. Eighteen subjects were enrolled in the study. The mean age of the subjects was 64.6 ± 14.2 y (55.5% were male), and the most common reason for ICU admission was pneumonia (n = 7; 38.8%). Perme scores increased from 11.3 (interquartile range 10.1–12.0) on the day before initiation of the speaking valve to 18.2 (IQR 16.2–20.1) immediately after the initiation of a speaking valve (P < .01). These changes were maintained during all periods of speaking valve use.CONCLUSION: The use of speaking valves in tracheostomized subjects improved mobility.