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DOI: 10.1055/s-0043-1767797
Effect of Speaking Valves on Tracheostomy Decannulation
Abstract
Introduction Despite several pediatric tracheostomy decannulation protocols there remains tremendous variability in practice. The effect of tracheostomy capping on decannulation has been studied but the role of speaking valves (SVs) is unknown.
Objective Given the positive benefits SVs have on rehabilitation, we hypothesized that SVs would decrease time to tracheostomy decannulation. The purpose of the present study was to evaluate this in a subset of patients with chronic lung disease of prematurity (CLD).
Methods A retrospective chart review was performed at a tertiary care children's hospital. A total of 105 patients with tracheostomies and CLD were identified. Data collected included demographics, gestational age, congenital cardiac disease, airway surgeries, granulation tissue excisions, SV and capping trials, tracheitis episodes, and clinic visits. Statistics were performed with logistic and linear regression.
Results A total of 75 patients were included. The mean gestational age was 27 weeks (standard deviation [SD] = 3.6) and the average birthweight was 1.1 kg (SD = 0.6). The average age at tracheostomy was 122 days (SD = 63). A total of 70.7% of the patients underwent decannulation and the mean time to decannulation (TTD) was 37 months (SD = 19). A total of 77.3% of the patients had SVs. Those with an SV had a longer TTD compared to those without (52 versus 35 months; p = 0.008). Decannulation was increased by 2 months for every increase in the number of hospital presentations for tracheitis (p = 0.011).
Conclusion The present study is the first, to our knowledge, to assess the effect of SVs on tracheostomy decannulation in patients with CLD showing a longer TTD when SVs are used.
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Introduction
Over 100,000 tracheotomies are performed every year. Only 5,000 are in children and 50% of these are performed in kids < 1 year old.[1] [2] [3] These tracheostomies are most commonly performed in children to allow for treatment of chronic lung disease (CLD) of prematurity, defined by patients that require supplemental oxygen at 28 postnatal days or 36 weeks postmenstrual age.[4] It is well known that pediatric tracheostomies present a higher risk than when performed in adults with complication rates between 15 and 19% and 10-year post tracheostomy mortality rates ranging from 9 to 15%.[3] [5] [6] [7] Furthermore, the tracheostomy specific mortality ranges from 0.5 to 5%.[8] Outside of medical complications, there is a significant financial and time burden for caregivers at home that negatively affects the caregiver's quality of life, sleep, and ability to work.[9] Understandably, there is heavy interest in caregivers, providers, patients, and hospitals in improving the decannulation process and decreasing time to decannulation (TTD).
Several pediatric tracheostomy decannulation protocols have been published, yet there is a wide variety of protocols followed by providers.[10] [11] [12] While the effect of tracheostomy capping on decannulation has been studied, the effect of speaking valves (SVs) is unknown.[13] [14] [15] Speaking valves allow for vocalization with a tracheostomy tube placement by redirecting airflow through the vocal folds during expiration. The positive effects of SVs are well studied and have been shown to improve quality of life, decrease risk of aspiration, improve swallow physiology, restore upper airway protective reflexes, normalize subglottic airway pressure, and improve gustation and olfaction.[16] [17] [18] [19] [20] [21] [22]
In the present study, we aimed to assess the utility and effectiveness of SVs to decrease TTD. To do so, we looked at a select group of complex pediatric patients, those with CLD requiring tracheostomy. In the process, we also assessed several other common diagnoses and clinical factors related to tracheostomies that we hypothesized would change TTD.
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Methods
Institutional review board approval was obtained (STUDY20060017). A retrospective chart review was performed at a tertiary children's hospital and the patients were reviewed from 2002 to 2019. A waiver for consent was obtained. In total, we identified 105 patients who underwent tracheostomy, carried a diagnosis of CLD, and did not have severe neurological disease. Patients were excluded if they were deceased before discharge after tracheostomy placement (n = 12), had tracheostomy tube placement after elective adenoidectomy complicated by respiratory syncytial virus (RSV) and acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) (n = 1), were deceased after hospital discharge (n = 7), were lost to follow-up (n = 7), were not discharged on mechanical ventilation (n = 2), and had bilateral vocal fold paralysis (n = 1). We then proceeded to collect variables from both the inpatient and outpatient settings.
Demographic and birth data were collected including weight and gestational age. A history of congenital cardiac disease, cardiac surgeries, and a history of pulmonary hypertension was also collected. Given the known prevalence of airway abnormalities in patients with prolonged endotracheal intubation, we also collected data on airway interventions prior to decannulation including tonsillectomy, balloon dilation, peristomal or suprastomal granulation tissue excision, and laryngotracheal reconstruction (LTR), which were further broken down into single stage and double stage procedures. Single stage involved LTR with tracheostomy decannulation at the same time as opposed to double stage which involves delayed tracheostomy decannulation.
From the outpatient settings, we collected data on the number of visits to pulmonology, to otolaryngology, as well as visits to the emergency department (ED) for tracheostomy-related complications and upper respiratory infections (URI). An episode of tracheitis was noted if it was the discharge diagnosis from the ED. Increased secretions were noted in addition to tracheitis and were not mutually exclusive with tracheitis. Chronic ventilator data was collected, including if the patient was discharged with a ventilator, the start of ventilatory sprints, and when the ventilator was completely weaned. Speaking valve trial data was collected as well as the TTD.
Statistics were performed with logistic and linear regression and the Mann-Whitney U test and the Likelihood Ratio test. Kaplan-Meier survival curves with Log Rank (Mantel-Cox) tests were used to assess statistical differences in TTD. Cox Regression was used for survival curves controlling for variables. Statistical analysis was performed with IBM SPSS Statistics for Windows version 24 (IBM Corp., Armonk, NY, USA) with p < 0.05 determining significance. Bonferroni multiple comparison correction was used when appropriate.
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Results
Out of 105 patients identified, 75 met the inclusion criteria and were included in our analysis. The study population included 45 males and 30 females with an average age at tracheostomy of 122 days (SD = 63) ([Table 1]). The mean gestational age was 27 weeks (SD = 3.6) and the average birth weight was 1.1 kg (SD = 0.6). Few patients were complicated by oligo- or polyhydramnios (4 [5%] versus 3 [4%], respectively). Suprastomal or peristomal granulation tissue excision was performed in 63 patients (84%; M (SD) number of excisions = 2.23 [1.99]) ([Table 2]). Balloon dilation (BD) was performed in 26 patients (34.7%; M (SD) number of BDs = 1.45 [2.62]). Laryngotracheal reconstruction of any stage was performed in 28 patients (37.3%).
Abbreviations: M, mean; Mdn, median; SD, standard deviation.
Bold indicates significance.
Bonferroni multiple comparison correction was used. P < 0.008 indicates significance.
Abbreviation: LTR, laryngotracheal reconstruction
Ultimately, 53 patients (70.7%) underwent tracheostomy decannulation and the mean TTD was 37 months (SD = 19) ([Figure 1A]). Prior to decannulation, 58 patients used SVs (77.3%). Those with an SV had a significantly longer TTD compared to those without SVs (Mean 52 versus 35 months, respectively, p = 0.008) ([Figure 1B]). Number of granulation tissue excisions in ENT clinic (p = 0.161), the operating room (OR) (p = 0.090), and overall (p = 0.425) did not significantly impact TTD ([Figure 2]). Emergency department visits for tracheitis (p = 0.137), secretions (p = 0.297), and URIs (p = 0.051) did not significant change TTD ([Figure 3]). When patients who had a single stage LTR (n = 20) were excluded, those with an SV still had a longer TTD (59 versus 30 months, respectively; p < 0.001 ([Figure 4A]). When excluding all patients with an LTR (n = 28), those with an SV also had a longer TTD (62 versus 25 months, p < 0.001) ([Figure 4B]). When controlling for a history of congenital heart disease requiring surgery and excluding those with single stage LTR, those with SV use had a higher probability of a longer TTD, p = 0.001 ([Figure 5]).
There was a significant increase in the number of granulation excisions in the ENT clinic in patients who would not be decannulated compared to those who were (M [SD] = 1.45 [2.39] versus 0.25 [0.48], respectively, p = 0.001) ([Table 3]). The number of granulation excisions in the ENT clinic was not correlated with the TTD (p = 0.242). Fifty-five patients (73%) presented to the ED with tracheitis. There was no significant increase in the number of visits for tracheitis in patients who were not decannulated compared with those who eventually were (p= 0.408). There was no difference in the likelihood of being decannulated predicted by the number of ED visits or admissions for tracheitis (p = 0.261). However, there was a significant positive correlation between TTD and number of ED visits or admissions for tracheitis (r = 0.347; p = 0.005). Decannulation was increased by 2.12 months for every additional visit to the ED or admission for tracheitis, (b = 2.12; t[51] = 2.64; p = 0.011). When Cox regression was performed with significant predictors (SV and ED/admission for tracheitis) as independent variables and TTD as the dependent variable, both SV (p = 0.014) and number of ED visits or admissions for tracheitis (p = 0.015) remained significantly associated with a decreased probability of discharge over time.
Abbreviations: ED, emergency department; ENT, Ear, Nose, and Throat; M, mean; Mdn, median; SD, standard deviation; URI, upper respiratory infection.
Bonferroni multiple comparison correction was used. p < 0.006 indicates significance.
There were no significant differences in the number of pulmonology and ENT clinic visits and visits to these departments with secretions, number of ED visits with URI and secretions, or the number of granulation excision in the OR between those who were and were not decannulated (p > 0.05) ([Table 3]).
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Discussion
The primary aim of our study was to assess whether SVs are effective in decreasing TTD in a complex population of pediatric patients with CLD requiring a tracheostomy. While prior studies have assessed tracheostomy capping and the effect of tracheostomy indication, age, and birth maturity on decannulation,[13] [14] [15] [23] here we report the first study, to our knowledge, of SVs on TTD. Factors influencing TTD are of interest given the significant burden tracheostomies place on caregivers and the immense amount of care a child will require though their lifetime.[9] [24]
Prior studies have reported a wide range of successful decannulation rates between 25 and 75%, which expectedly vary depending upon substantial differences in the indication for tracheostomy and comorbidities of the study population, follow-up, and institutional practices.[24] [25] [26] [27] [28] [29] Our study limited these variations by selecting tracheostomy patients who had been diagnosed with CLD. However, there are a wide range of patient factors that could have contributed to candidacy for decannulation, such as supraglottic patency and neurologic status. In addition, similar to other studies, the present study is limited by its retrospective nature and the limitations inherent to that study design. Furthermore, our institution has had over 20 pediatric otolaryngologists over the course of this review without any standardized protocol for SV use leading to a wide variety of practice despite our attempts to make this population as uniform as possible. Additionally, our study lacks statistical power to detect some differences; however, we are limited by our patient population. A multicenter study would be optimal to detect differences.
Compared with other decannulation studies, our study fell on the higher end of this range with 70.7% of patients being decannulated and a mean TTD of 37 months (SD = 19), despite representing a premature population with a mean gestational age of 27 weeks (SD = 3.6). The majority of our patients utilized an SV prior to decannulation (77.3%), and contrary to our hypothesis, SVs were associated with a longer TTD compared to those without SVs (52 versus 35 months, respectively, p = 0.008). Despite controlling for several prematurity-related pathophysiologic processes including congenital heart diseases and airway surgeries related to subglottic stenosis, this result continued to hold true. However, it must be taken with caution as there is likely a strong component of selection bias where patients with longer TTD and patients that are seen in clinic more frequently are more likely to have an SV trial. In addition, longer planned TTD due to comorbidities may have made providers and caregivers more likely to pursue SV trials to encourage speech and language development while waiting for the child to achieve candidacy for decannulation. It is possible that the slight increase in positive end-expiratory pressure (PEEP) generated by an SV may result in prolonged TTD; however, further studies will be needed to evaluate this. Ultimately, we do not believe that this data should be used to discourage patients or providers from utilizing SVs as this would ignore the psychosocial and developmental benefits provided by these devices.
Although the present study was not designed to demonstrate the benefits of SVs other than decreased TTD, evidence supporting these benefits has been provided in previous pediatric literature. Zabih et al. performed a scoping review of the literature available in 2016.[30] They identified 8 studies reporting verbal communication with SV use.[31] [32] [33] [34] [35] [36] [37] [38] More recently, Buswell et al. reported improvements in phonation (new phonation in a previously aphonic child or increase in spontaneous phonation time) in 76% of children with SV.[39] Even in prelingual infants and children with neurologic deficits impacting verbal communication goals, the ability to produce audible crying and nonspecific vocalization can significantly improve patient safety and quality the of life of caregivers. Regarding benefits outside of vocalization, Ongkasuwan et al. reported a reduction in pyriform sinus residue, although no studies have demonstrated a significant reduction in aspiration with SV use.[37] [40] Improvement in cough and constipation have also been theorized due to the ability to generate supraglottic pressure and perform Valsalva, respectively, although supporting evidence in children is absent.[37] [41] Notably, there is a paucity of studies identifying nonvocalization outcomes as primary or secondary outcome measures in children with SV, especially when compared with the adult literature. This gap highlights the need for future research including both objective outcomes and parent report measures to better define the benefit/risk ratio for SV in children and guide clinical decision-making.
It is also worth noting that there was a significant increase in the number of granulation excisions performed in the ENT clinic in patients who would not be decannulated, although the number of excisions was not correlated with TTD. Similar to the selection bias hypothesized to be occurring in SV placement, patients not able to be decannulated may have been seen more frequently and had increased number of granulation excisions. Furthermore, we found a positive correlation between TTD and the number of ED visits or admissions for tracheitis, with TTD being increased by 2.12 months for every additional visit to the ED or admission for tracheitis. Patients with tracheitis who required a hospital visit likely required more follow-up visits and treatment that further delayed their decannulation. This finding highlights the importance of diagnosing and treating tracheitis early and effectively, as it can have long lasting impacts on time requiring a tracheostomy tube.
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Conclusion
The present study is the first, to our knowledge, to assess the effect of SVs on tracheostomy decannulation in patients with CLD. We show that SVs are associated with longer TTD, even when controlling for patients that required congenital heart surgery or LTR. Speech valves have been shown to improve the rehabilitation process in many ways, and we believe their use should be encouraged. However, the association between SVs and a prolonged decannulation process is something providers should be aware of, as this relationship is further studied.
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Conflict of Interests
The authors have no conflict of interests to declare.
The present work was presented virtually as a podium presentation at the American Academy of Otolaryngology- Head and Neck Surgery Conference from September 13- October 25, 2020.
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References
- 1 Baker CD. Long-term ventilation for children with chronic lung disease of infancy. Curr Opin Pediatr 2019; 31 (03) 357-366 DOI: 10.1097/MOP.0000000000000757.
- 2 Berry JG, Graham DA, Graham RJ. et al. Predictors of clinical outcomes and hospital resource use of children after tracheotomy. Pediatrics 2009; 124 (02) 563-572 DOI: 10.1542/peds.2008-3491.
- 3 Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in pediatric tracheostomies. Laryngoscope 2001; 111 (11 Pt 1): 1925-1928 DOI: 10.1097/00005537-200111000-00010.
- 4 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729 DOI: 10.1164/ajrccm.163.7.2011060.
- 5 Carter P, Benjamin B. Ten-year review of pediatric tracheotomy. Ann Otol Rhinol Laryngol 1983; 92 (4 Pt 1): 398-400 DOI: 10.1177/000348948309200422.
- 6 Cristea AI, Ackerman VL, Davis SD. et al. Median household income: association with mortality in children on chronic ventilation at home secondary to bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol 2015; 28 (01) 41-46 DOI: 10.1089/ped.2014.0406.
- 7 Cristea AI, Carroll AE, Davis SD, Swigonski NL, Ackerman VL. Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home. Pediatrics 2013; 132 (03) e727-e734 DOI: 10.1542/peds.2012-2990.
- 8 D'Souza JN, Levi JR, Park D, Shah UK. Complications following pediatric tracheotomy. JAMA Otolaryngol Head Neck Surg 2016; 142 (05) 484-488 DOI: 10.1001/jamaoto.2016.0173.
- 9 Funamura JL, Durbin-Johnson B, Tollefson TT, Harrison J, Senders CW. Pediatric tracheotomy: indications and decannulation outcomes. Laryngoscope 2014; 124 (08) 1952-1958 DOI: 10.1002/lary.24596.
- 10 Gray RF, Todd NW, Jacobs IN. Tracheostomy decannulation in children: approaches and techniques. Laryngoscope 1998; 108 (1 Pt 1): 8-12 DOI: 10.1097/00005537-199801000-00002.
- 11 Hopkins C, Whetstone S, Foster T, Blaney S, Morrison G. The impact of paediatric tracheostomy on both patient and parent. Int J Pediatr Otorhinolaryngol 2009; 73 (01) 15-20 DOI: 10.1016/j.ijporl.2008.09.010.
- 12 Overman AE, Liu M, Kurachek SC. et al. Tracheostomy for infants requiring prolonged mechanical ventilation: 10 years' experience. Pediatrics 2013; 131 (05) e1491-e1496 DOI: 10.1542/peds.2012-1943.
- 13 Quinlan C, Piccione J, Kim JY. et al. The role of polysomnography in tracheostomy decannulation of children with bronchopulmonary dysplasia. Pediatr Pulmonol 2019; 54 (11) 1676-1683 DOI: 10.1002/ppul.24474.
- 14 Mandy G, Malkar M, Welty SE. et al. Tracheostomy placement in infants with bronchopulmonary dysplasia: safety and outcomes. Pediatr Pulmonol 2013; 48 (03) 245-249 DOI: 10.1002/ppul.22572.
- 15 Mitchell RB, Hussey HM, Setzen G. et al. Clinical consensus statement: tracheostomy care. Otolaryngol Head Neck Surg 2013; 148 (01) 6-20 DOI: 10.1177/0194599812460376.
- 16 Bergbom-Engberg I, Haljamäe H. Assessment of patients' experience of discomforts during respirator therapy. Crit Care Med 1989; 17 (10) 1068-1072 DOI: 10.1097/00003246-198910000-00021.
- 17 Elpern EH, Borkgren Okonek M, Bacon M, Gerstung C, Skrzynski M. Effect of the Passy-Muir tracheostomy speaking valve on pulmonary aspiration in adults. Heart Lung 2000; 29 (04) 287-293 DOI: 10.1067/mhl.2000.106941.
- 18 Eibling DE, Gross RD. Subglottic air pressure: a key component of swallowing efficiency. Ann Otol Rhinol Laryngol 1996; 105 (04) 253-258 DOI: 10.1177/000348949610500401.
- 19 Lichtman SW, Birnbaum IL, Sanfilippo MR, Pellicone JT, Damon WJ, King ML. Effect of a tracheostomy speaking valve on secretions, arterial oxygenation, and olfaction: a quantitative evaluation. J Speech Hear Res 1995; 38 (03) 549-555 DOI: 10.1044/jshr.3803.549.
- 20 Prigent H, Lejaille M, Terzi N. et al. Effect of a tracheostomy speaking valve on breathing-swallowing interaction. Intensive Care Med 2012; 38 (01) 85-90 DOI: 10.1007/s00134-011-2417-8.
- 21 Gross RD, Mahlmann J, Grayhack JP. Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow. Ann Otol Rhinol Laryngol 2003; 112 (02) 143-152 DOI: 10.1177/000348940311200207.
- 22 Stachler RJ, Hamlet SL, Choi J, Fleming S. Scintigraphic quantification of aspiration reduction with the Passy-Muir valve. Laryngoscope 1996; 106 (2 Pt 1): 231-234 DOI: 10.1097/00005537-199602000-00024.
- 23 Falla PI, Westhoff JH, Bosch N, Federspil PA. Factors influencing time-dependent decannulation after pediatric tracheostomy according to the Kaplan-Meier method. Eur Arch Otorhinolaryngol 2020; 277 (04) 1139-1147 DOI: 10.1007/s00405-020-05827-w.
- 24 Abode KA, Drake AF, Zdanski CJ, Retsch-Bogart GZ, Gee AB, Noah TL. A multidisciplinary children's airway center: impact on the care of patients with tracheostomy. Pediatrics 2016; 137 (02) e20150455 DOI: 10.1542/peds.2015-0455.
- 25 Mahadevan M, Barber C, Salkeld L, Douglas G, Mills N. Pediatric tracheotomy: 17 year review. Int J Pediatr Otorhinolaryngol 2007; 71 (12) 1829-1835 DOI: 10.1016/j.ijporl.2007.08.007.
- 26 French LC, Wootten CT, Thomas RG, Neblett III WW, Werkhaven JA, Cofer SA. Tracheotomy in the preschool population: indications and outcomes. Otolaryngol Head Neck Surg 2007; 137 (02) 280-283 DOI: 10.1016/j.otohns.2007.02.021.
- 27 Özmen S, Özmen ÖA, Ünal ÖF. Pediatric tracheotomies: a 37-year experience in 282 children. Int J Pediatr Otorhinolaryngol 2009; 73 (07) 959-961 DOI: 10.1016/j.ijporl.2009.03.020.
- 28 de Trey L, Niedermann E, Ghelfi D, Gerber A, Gysin C. Pediatric tracheotomy: a 30-year experience. J Pediatr Surg 2013; 48 (07) 1470-1475 DOI: 10.1016/j.jpedsurg.2012.09.066.
- 29 Tantinikorn W, Alper CM, Bluestone CD, Casselbrant ML. Outcome in pediatric tracheotomy. Am J Otolaryngol 2003; 24 (03) 131-137 DOI: 10.1016/S0196-0709(03)00009-7.
- 30 Zabih W, Holler T, Syed F, Russell L, Allegro J, Amin R. The use of speaking valves in children with tracheostomy tubes. Respir Care 2017; 62 (12) 1594-1601 DOI: 10.4187/respcare.0559931.
- 31 Brigger MT, Hartnick CJ. Drilling speaking valves: a modification to improve vocalization in tracheostomy dependent children. Laryngoscope 2009; 119 (01) 176-179 DOI: 10.1002/lary.20077.
- 32 Buckland A, Jackson L, Ilich T, Lipscombe J, Jones G, Vijayasekaran S. Drilling speaking valves to promote phonation in tracheostomy-dependent children. Laryngoscope 2012; 122 (10) 2316-2322 DOI: 10.1002/lary.23436.
- 33 Cho Lieu JE, Muntz HR, Prater D, Blount Stahl M. Passy-Muir valve in children with tracheotomy. Int J Pediatr Otorhinolaryngol 1999; 50 (03) 197-203 DOI: 10.1016/s0165-5876(99)00245-1.
- 34 Engleman SG, Turnage-Carrier C. Tolerance of the Passy-Muir Speaking Valve in infants and children less than 2 years of age. Pediatr Nurs 1997; 23 (06) 571-573
- 35 Fraser J, Pengilly A, Mok Q. Long-term ventilator-dependent children: a vocal profile analysis. Pediatr Rehabil 1998; 2 (02) 71-75 DOI: 10.3109/17518429809068158.
- 36 Gereau SA, Navarro GC, Cluterio B, Mullan E, Bassila M, Ruben RJ. Selection of pediatric patients for use of the Passy-Muir valve for speech production. Int J Pediatr Otorhinolaryngol 1996; 35 (01) 11-17 DOI: 10.1016/0165-5876(95)01258-3.
- 37 Hull EM, Dumas HM, Crowley RA, Kharasch VS. Tracheostomy speaking valves for children: tolerance and clinical benefits. Pediatr Rehabil 2005; 8 (03) 214-219 DOI: 10.1080/13638490400021503.
- 38 Torres LY, Sirbegovic DJ. Clinical benefits of the Passy-Muir tracheostomy and ventilator speaking valves in the NICU. Neonatal Intensive Care: The Journal of Perinatology-Neonatology 2004; 17 (04) 20-23
- 39 Buswell C, Powell J, Powell S. Paediatric tracheostomy speaking valves: our experience of forty-two children with an adapted Passy-Muir® speaking valve. Clin Otolaryngol 2017; 42 (04) 941-944 DOI: 10.1111/coa.12776.
- 40 Ongkasuwan J, Turk CL, Rappazzo CA, Lavergne KA, Smith EO, Friedman EM. The effect of a speaking valve on laryngeal aspiration and penetration in children with tracheotomies. Laryngoscope 2014; 124 (06) 1469-1474 DOI: 10.1002/lary.24457.
- 41 Simons JP, Mehta D, Mandell DL. Assessment of constipation in children with tracheostomy. Arch Otolaryngol Head Neck Surg 2010; 136 (01) 27-32 DOI: 10.1001/archoto.2009.207.
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Eingereicht: 12. April 2022
Angenommen: 05. Dezember 2022
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06. Oktober 2023
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References
- 1 Baker CD. Long-term ventilation for children with chronic lung disease of infancy. Curr Opin Pediatr 2019; 31 (03) 357-366 DOI: 10.1097/MOP.0000000000000757.
- 2 Berry JG, Graham DA, Graham RJ. et al. Predictors of clinical outcomes and hospital resource use of children after tracheotomy. Pediatrics 2009; 124 (02) 563-572 DOI: 10.1542/peds.2008-3491.
- 3 Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in pediatric tracheostomies. Laryngoscope 2001; 111 (11 Pt 1): 1925-1928 DOI: 10.1097/00005537-200111000-00010.
- 4 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729 DOI: 10.1164/ajrccm.163.7.2011060.
- 5 Carter P, Benjamin B. Ten-year review of pediatric tracheotomy. Ann Otol Rhinol Laryngol 1983; 92 (4 Pt 1): 398-400 DOI: 10.1177/000348948309200422.
- 6 Cristea AI, Ackerman VL, Davis SD. et al. Median household income: association with mortality in children on chronic ventilation at home secondary to bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol 2015; 28 (01) 41-46 DOI: 10.1089/ped.2014.0406.
- 7 Cristea AI, Carroll AE, Davis SD, Swigonski NL, Ackerman VL. Outcomes of children with severe bronchopulmonary dysplasia who were ventilator dependent at home. Pediatrics 2013; 132 (03) e727-e734 DOI: 10.1542/peds.2012-2990.
- 8 D'Souza JN, Levi JR, Park D, Shah UK. Complications following pediatric tracheotomy. JAMA Otolaryngol Head Neck Surg 2016; 142 (05) 484-488 DOI: 10.1001/jamaoto.2016.0173.
- 9 Funamura JL, Durbin-Johnson B, Tollefson TT, Harrison J, Senders CW. Pediatric tracheotomy: indications and decannulation outcomes. Laryngoscope 2014; 124 (08) 1952-1958 DOI: 10.1002/lary.24596.
- 10 Gray RF, Todd NW, Jacobs IN. Tracheostomy decannulation in children: approaches and techniques. Laryngoscope 1998; 108 (1 Pt 1): 8-12 DOI: 10.1097/00005537-199801000-00002.
- 11 Hopkins C, Whetstone S, Foster T, Blaney S, Morrison G. The impact of paediatric tracheostomy on both patient and parent. Int J Pediatr Otorhinolaryngol 2009; 73 (01) 15-20 DOI: 10.1016/j.ijporl.2008.09.010.
- 12 Overman AE, Liu M, Kurachek SC. et al. Tracheostomy for infants requiring prolonged mechanical ventilation: 10 years' experience. Pediatrics 2013; 131 (05) e1491-e1496 DOI: 10.1542/peds.2012-1943.
- 13 Quinlan C, Piccione J, Kim JY. et al. The role of polysomnography in tracheostomy decannulation of children with bronchopulmonary dysplasia. Pediatr Pulmonol 2019; 54 (11) 1676-1683 DOI: 10.1002/ppul.24474.
- 14 Mandy G, Malkar M, Welty SE. et al. Tracheostomy placement in infants with bronchopulmonary dysplasia: safety and outcomes. Pediatr Pulmonol 2013; 48 (03) 245-249 DOI: 10.1002/ppul.22572.
- 15 Mitchell RB, Hussey HM, Setzen G. et al. Clinical consensus statement: tracheostomy care. Otolaryngol Head Neck Surg 2013; 148 (01) 6-20 DOI: 10.1177/0194599812460376.
- 16 Bergbom-Engberg I, Haljamäe H. Assessment of patients' experience of discomforts during respirator therapy. Crit Care Med 1989; 17 (10) 1068-1072 DOI: 10.1097/00003246-198910000-00021.
- 17 Elpern EH, Borkgren Okonek M, Bacon M, Gerstung C, Skrzynski M. Effect of the Passy-Muir tracheostomy speaking valve on pulmonary aspiration in adults. Heart Lung 2000; 29 (04) 287-293 DOI: 10.1067/mhl.2000.106941.
- 18 Eibling DE, Gross RD. Subglottic air pressure: a key component of swallowing efficiency. Ann Otol Rhinol Laryngol 1996; 105 (04) 253-258 DOI: 10.1177/000348949610500401.
- 19 Lichtman SW, Birnbaum IL, Sanfilippo MR, Pellicone JT, Damon WJ, King ML. Effect of a tracheostomy speaking valve on secretions, arterial oxygenation, and olfaction: a quantitative evaluation. J Speech Hear Res 1995; 38 (03) 549-555 DOI: 10.1044/jshr.3803.549.
- 20 Prigent H, Lejaille M, Terzi N. et al. Effect of a tracheostomy speaking valve on breathing-swallowing interaction. Intensive Care Med 2012; 38 (01) 85-90 DOI: 10.1007/s00134-011-2417-8.
- 21 Gross RD, Mahlmann J, Grayhack JP. Physiologic effects of open and closed tracheostomy tubes on the pharyngeal swallow. Ann Otol Rhinol Laryngol 2003; 112 (02) 143-152 DOI: 10.1177/000348940311200207.
- 22 Stachler RJ, Hamlet SL, Choi J, Fleming S. Scintigraphic quantification of aspiration reduction with the Passy-Muir valve. Laryngoscope 1996; 106 (2 Pt 1): 231-234 DOI: 10.1097/00005537-199602000-00024.
- 23 Falla PI, Westhoff JH, Bosch N, Federspil PA. Factors influencing time-dependent decannulation after pediatric tracheostomy according to the Kaplan-Meier method. Eur Arch Otorhinolaryngol 2020; 277 (04) 1139-1147 DOI: 10.1007/s00405-020-05827-w.
- 24 Abode KA, Drake AF, Zdanski CJ, Retsch-Bogart GZ, Gee AB, Noah TL. A multidisciplinary children's airway center: impact on the care of patients with tracheostomy. Pediatrics 2016; 137 (02) e20150455 DOI: 10.1542/peds.2015-0455.
- 25 Mahadevan M, Barber C, Salkeld L, Douglas G, Mills N. Pediatric tracheotomy: 17 year review. Int J Pediatr Otorhinolaryngol 2007; 71 (12) 1829-1835 DOI: 10.1016/j.ijporl.2007.08.007.
- 26 French LC, Wootten CT, Thomas RG, Neblett III WW, Werkhaven JA, Cofer SA. Tracheotomy in the preschool population: indications and outcomes. Otolaryngol Head Neck Surg 2007; 137 (02) 280-283 DOI: 10.1016/j.otohns.2007.02.021.
- 27 Özmen S, Özmen ÖA, Ünal ÖF. Pediatric tracheotomies: a 37-year experience in 282 children. Int J Pediatr Otorhinolaryngol 2009; 73 (07) 959-961 DOI: 10.1016/j.ijporl.2009.03.020.
- 28 de Trey L, Niedermann E, Ghelfi D, Gerber A, Gysin C. Pediatric tracheotomy: a 30-year experience. J Pediatr Surg 2013; 48 (07) 1470-1475 DOI: 10.1016/j.jpedsurg.2012.09.066.
- 29 Tantinikorn W, Alper CM, Bluestone CD, Casselbrant ML. Outcome in pediatric tracheotomy. Am J Otolaryngol 2003; 24 (03) 131-137 DOI: 10.1016/S0196-0709(03)00009-7.
- 30 Zabih W, Holler T, Syed F, Russell L, Allegro J, Amin R. The use of speaking valves in children with tracheostomy tubes. Respir Care 2017; 62 (12) 1594-1601 DOI: 10.4187/respcare.0559931.
- 31 Brigger MT, Hartnick CJ. Drilling speaking valves: a modification to improve vocalization in tracheostomy dependent children. Laryngoscope 2009; 119 (01) 176-179 DOI: 10.1002/lary.20077.
- 32 Buckland A, Jackson L, Ilich T, Lipscombe J, Jones G, Vijayasekaran S. Drilling speaking valves to promote phonation in tracheostomy-dependent children. Laryngoscope 2012; 122 (10) 2316-2322 DOI: 10.1002/lary.23436.
- 33 Cho Lieu JE, Muntz HR, Prater D, Blount Stahl M. Passy-Muir valve in children with tracheotomy. Int J Pediatr Otorhinolaryngol 1999; 50 (03) 197-203 DOI: 10.1016/s0165-5876(99)00245-1.
- 34 Engleman SG, Turnage-Carrier C. Tolerance of the Passy-Muir Speaking Valve in infants and children less than 2 years of age. Pediatr Nurs 1997; 23 (06) 571-573
- 35 Fraser J, Pengilly A, Mok Q. Long-term ventilator-dependent children: a vocal profile analysis. Pediatr Rehabil 1998; 2 (02) 71-75 DOI: 10.3109/17518429809068158.
- 36 Gereau SA, Navarro GC, Cluterio B, Mullan E, Bassila M, Ruben RJ. Selection of pediatric patients for use of the Passy-Muir valve for speech production. Int J Pediatr Otorhinolaryngol 1996; 35 (01) 11-17 DOI: 10.1016/0165-5876(95)01258-3.
- 37 Hull EM, Dumas HM, Crowley RA, Kharasch VS. Tracheostomy speaking valves for children: tolerance and clinical benefits. Pediatr Rehabil 2005; 8 (03) 214-219 DOI: 10.1080/13638490400021503.
- 38 Torres LY, Sirbegovic DJ. Clinical benefits of the Passy-Muir tracheostomy and ventilator speaking valves in the NICU. Neonatal Intensive Care: The Journal of Perinatology-Neonatology 2004; 17 (04) 20-23
- 39 Buswell C, Powell J, Powell S. Paediatric tracheostomy speaking valves: our experience of forty-two children with an adapted Passy-Muir® speaking valve. Clin Otolaryngol 2017; 42 (04) 941-944 DOI: 10.1111/coa.12776.
- 40 Ongkasuwan J, Turk CL, Rappazzo CA, Lavergne KA, Smith EO, Friedman EM. The effect of a speaking valve on laryngeal aspiration and penetration in children with tracheotomies. Laryngoscope 2014; 124 (06) 1469-1474 DOI: 10.1002/lary.24457.
- 41 Simons JP, Mehta D, Mandell DL. Assessment of constipation in children with tracheostomy. Arch Otolaryngol Head Neck Surg 2010; 136 (01) 27-32 DOI: 10.1001/archoto.2009.207.