EFFECT OF THE PASSY-MUIR VALVE ON ASPIRATION IN PATIENTS WITH TRACHEOSTOMY

Objective. To assess potential benefit of a Passy-Muir Speaking Valve (PMV) in decreasing aspiration in patients with a tracheostomy. Backgr ound. Many patients with tracheostomy exhibit clinically significant a spiration. It has been previously noted that aspiration can often be r educed or eliminated by plugging or removing the tracheostomy tube. So me patients, however, do not tolerate removal or plugging of their tra cheostomy tube, which then leads to persistent aspiration. We postulat ed that a one-way speaking valve may restore more normal subglottic an d glottic air flow and reduce aspiration. Methods. Alert patients with a tracheostomy and clinical evidence of aspiration were eligible for study. Eleven patients with tracheostomy and known aspiration were stu died with a modified barium swallow. Radiographic examination was used to evaluate the presence and amount of aspiration while patients swal lowed both with and without a PMV in place on their tracheostomy tube. Results. Aspiration was reduced (or eliminated) during swallowing in all 11 patients when they wore a PMV, when compared to swallowing with an open (unvalved) tube. This improvement was achieved with liquids, semisolids, and pureed consistencies. Conclusion. This study demonstra tes that a Passy-Muir speaking valve facilitated swallow and reduced a spiration in patients with a tracheostomy and known aspiration.