Voice‐Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial

• Published in: The Laryngoscope 2020-05, Vol.130 (5), p.1249-1255
• Main Authors: Pandian, Vinciya, Cole, Therese, Kilonsky, Dana, Holden, Kate, Feller‐Kopman, David J., Brower, Roy, Mirski, Marek
• Format: Article
• Language: English
• Subjects: critically ill; mechanical ventilation; Ostomy; Quality of life; tracheostomy; Voice
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.28211

Objective The primary objective of our study was to determine the quality of life (QOL) using a talking tracheostomy tube. Methods Randomized clinical trial (NCT2018562). Adult intensive care unit patients who were mechanically ventilated, awake, alert, attempting to communicate, English‐speaking, and could not tolerate one‐way speaking valve were included. Intervention comprised a Blue Line Ultra Suctionaid (BLUSA) talking tracheostomy tube (Smiths Medical, Dublin, OH, US). Outcome measures included QOL scores measured using Quality of Life in Mechanically Ventilated Patients (QOL‐MV) and Voice‐Related Quality of Life (V‐RQOL), Speech Intelligibility Test (SIT) scores, independence, and satisfaction. Results The change in V‐RQOL scores from pre‐ to postintervention was higher among patients using a BLUSA (Smiths Medical) compared to those who did not (P = 0.001). The QOL‐MV scores from pre‐ to postintervention were significantly higher among patients who used a BLUSA (Smiths Medical) compared to patients who did not use BLUSA (Smiths Medical) or a one‐way speaking valve (P = 0.04). SIT scores decreased by 6.4 points for each 1‐point increase in their Sequential Organ Failure Assessment scores (P = 0.04). The overall QOL‐MV scores correlated moderately with the overall V‐RQOL scores (correlation coefficient = 0.59). Cronbach alpha score for overall QOL‐MV was 0.71. Seventy‐three percent of the 22 intervention patients reported the ability to use the BLUSA (Smiths Medical) with some level of independence, whereas 41% reported some level of satisfaction with the use of BLUSA (Smiths Medical). The lengths of stay was longer in the intervention group. Conclusion Our study suggests that BLUSA (Smiths Medical) talking tracheostomy tube improves patient‐reported QOL in mechanically ventilated patients with a tracheostomy who cannot tolerate cuff deflation. Level of Evidence I Laryngoscope, 130:1249–1255, 2020