PT  - JOURNAL ARTICLE
AU  - Ceron, Camila
AU  - Otto, Danielle
AU  - Signorini, Alana Verza
AU  - Beck, Marco Colomé
AU  - Camilis, Marcio
AU  - Sganzerla, Daniel
AU  - Rosa, Régis Goulart
AU  - Teixeira, Cassiano
TI  - The Effect of Speaking Valves on ICU Mobility of Individuals With Tracheostomy
AID  - 10.4187/respcare.06768
DP  - 2020 Feb 01
TA  - Respiratory Care
PG  - 144--149
VI  - 65
IP  - 2
4099  - http://rc.rcjournal.com/content/65/2/144.short
4100  - http://rc.rcjournal.com/content/65/2/144.full
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.CONCLUSIONS: The use of speaking valves in tracheostomized subjects improved mobility.