Sage Journals: Discover world-class research

Abstract

Early speaking valve application in children with tracheostomies is encouraged for language development. Whether an institutional multidisciplinary protocol impacts the patient population and timelines for which a speaking valve is trialed has not been studied. This retrospective study compared speaking valve trials performed at a pediatric quaternary hospital over a 12-year period. Timelines (time between tracheostomy insertion, speech-language pathologist (SLP) consultation, speaking valve order, and trial) and patient characteristics (demographics, tracheostomy classification, and feeding status) were collected. Medians (IQRs) compared timelines before and after a protocol was instituted and compared the timelines between tracheostomy classifications. Median time between tracheostomy insertion and SLP consultation did not change: before protocol-1.8 (7.7) months and after protocol-1.8 (2.4) months. Time between tracheostomy insertion and speaking valve trial decreased: before protocol-34.1 (40.5) months and after protocol-12.9 (8.4) months. Time between tracheostomy insertion and trial was not different between tracheostomy classifications: upper airway obstruction-16.0 (27.1) months, complex medical condition-36.3 (45.8) months, and invasive ventilation-17.5 (22.3) months. An institutional multidisciplinary protocol decreases the time between tracheostomy insertion and speaking valve trial, regardless of the reason the tracheostomy is needed in the pediatric population.

Keywords

health services research interdisciplinary communication pediatrics tracheostomy

Get full access to this article

View all access options for this article.

References

Alberta Health Services (2013) Tracheostomy – Speaking Valve Trials. Internal Resource.

Al-Samri

Mitchell

Drummond

, et al. (2010) Tracheostomy in children: a population-based experience over 17 years. Pediatric Pulmonology 45(5): 487–493.

Baker

Blackwell

(2001) Adult and infant vocalization: speaking valves used in individuals with tracheostomy and ventilator dependency. Journal of the Kentucky Medical Association 99(5): 193–203.

Baumgartner

Bewyer

Bruner

(2008) Management of communication and swallowing in intensive care. AACN Advanced Critical Care 19(4): 433–443.

Brookes

Figueroa

Edwards

(2020) Passy Muir valve tolerance in medically complex infants and children: are there predictors for success? The Laryngoscope 130(11): E632–E639.

Cameron

McKinstry

Burt

, et al. (2009) Outcomes of patients with spinal cord injury before and after introduction of an interdisciplinary tracheostomy team. Critical Care and Resuscitation 11: 14–19.

Cho Lieu

Muntz

Prater

, et al. (1999) Passy-Muir valve in children with tracheotomy. International Journal of Pediatric Otorhinolaryngology 50: 197–203.

De Mestral

Igbal

Fong

, et al. (2011) Impact of a specialized multidisciplinary tracheostomy team on tracheostomy care in critically ill patients. Canadian Journal of Surgery 54(3): 167–172.

Englemen

Turnage-Carrier

(1997) Tolerance of the Passy-Muir speaking valve ™ in infants and children less than 2 years of age. Pediatric Nursing 23(6): 571–573.

10.

Franklin

Warlaumont

Messinger

, et al. (2014) Effects of parental interaction on infant vocalization rate, variability and vocal type. Language Learning and Development 10(3): 279–299.

11.

Gereau

Navarro

Cluterio

, et al. (1996) Selection of pediatric patients for use of the Passy-Muir valve for speech production. International Journal of Pediatric Otorhinolaryngology 35: 11–17.

12.

Greene

Davenport

Fitzgerald

, et al. (2019) Tracheostomy speaking valve modification in children: a standardized approach leads to widespread use. Pediatric Pulmonology 54: 428–435.

13.

Hess

(2005) Facilitating speech in the patient with a tracheostomy. Respiratory Care 50(4): 519–525.

14.

Hull

Dumas

Crowley

, et al. (2005) Tracheostomy speaking valves for children: tolerance and clinical benefits. Pediatric Rehabilitation 8(3): 214–219.

15.

Kamen

Watson

(1994) Effects of long-term tracheostomy on spectral characteristics of vowel production. Journal of Speech, Language, and Hearing Research 34: 1057–1065.

16.

Kaslon

Stein

(1985) Chronic pediatric tracheotomy: assessment and implications for habilitation of voice, speech and language in young children. International Journal of Pediatric Otorhinolaryngology 9: 165–171.

17.

Kertoy

Guest

Quart

, et al. (1999) Speech and phonological characteristics of individual children with a history of tracheostomy. Journal of Speech, Language, and Hearing Research 42: 621–635.

18.

LeBlanc

Shultz

Seresova

, et al. (2010) Outcome in tracheostomized patients with severe traumatic brain injury following implementation of a specialized multidisciplinary. Journal of Head Trauma Rehabilitation 25(5): 362–365.

19.

Liu

Heffernan

Saluja

, et al. (2014) Indications, hospital course, and complexity of patients undergoing tracheostomy at a tertiary care pediatric hospital. Otolaryngology – Head and Neck Surgery 151(2): 232–239.

20.

Manzano

Lubillo

Henriquez

, et al. (1993) Verbal communication in ventilator-dependent patients. Critical Care Medicine 21: 512–517.

21.

McGowan

Bleile

Fus

, et al. (1993) Communication disorders. In: Bleile

(ed) The Care of Children with Long-Term Tracheostomies. San Diego, CA: Singular Publishing Group, 116.

22.

Sellers

Mandy

Pennington

, et al. (2014) Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy. Developmental Medicine and Child Neurology 56(3): 245–251.

23.

Stark

(1980) Stages of speech development in the first year of life. In: Yeni-Komshian

Kavanagh

Ferguson

(eds) Child Phonology. New York, NY: Academic Press, 73–92.

24.

Watters

(2017) Tracheostomy in infants and children. Respiratory Care 62(6): 799–825.

25.

Woodnorth

(2004) Assessing and managing medically fragile children: tracheostomy and ventilatory support. Language, Speech, and Hearing Services in Schools 35: 363–372.

26.

Zabih

Holler

Syed

, et al. (2017) The use of speaking valves in children with tracheostomy tubes. Respiratory Care 62(12): 1594–1601.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.17 MB

Pediatric tracheostomy speaking valves: A multidisciplinary protocol leads to earlier initial trials

Abstract

Keywords

Get full access to this article

References

Supplementary Material