Investigating the impact of in-line speaking valves on the weaning of intensive care patients from mechanical ventilation

Julia Comben1

1Qld Health, Brisbane, Australia

Patients requiring mechanical ventilation via an artificial airway in the form of a tracheostomy are unable to verbally communicate as a result of an inflated tracheostomy cuff impeding airflow through the upper airway, and subsequently the larynx. Speaking valves are designed to allow airflow through the larynx to facilitate phonation by deflating the tracheostomy cuff and redirecting air through the upper airway on exhalation.

The lack of verbal communication associated with tracheostomy placement has been shown to have a negative psychological impact on patients. Research has demonstrated that increased use of speaking valves in critically ill patients has the potential to improve patient’s quality of life by restoring verbal communication.

Previously the use of speaking valves to facilitate verbal communication in mechanically ventilated tracheostomy patients was restricted by concerns regarding potentially detrimental effects to respiratory status and ventilator weaning. Research previously conducted at The Prince Charles Hospital (TPCH) successfully demonstrated that the use of in line speaking valves with mechanically ventilated patients in a predominately cardiothoracic intensive care unit resulted in an increase in end expiratory lung impedance, and did not have a negative impact on lung recruitment. As a result of this research, the use of in line speaking valves has become usual practice with mechanically ventilated patients in TPCH intensive care unit.

This audit is to review the impact of inline speaking valves and the weaning of tracheostomy patients from mechanical ventilation within the intensive care unit as a comparison to previously conducted research to support current practice.


Julia is a speech pathologist currently working at The Prince Charles Hospital in Brisbane.  She obtained her bachelor’s degree in speech pathology from the University of Queensland in 2015. She has clinical experience within adult tertiary hospitals, largely within the acute and critical care caseloads.

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