EFFECT OF A TRACHEOSTOMY SPEAKING VALVE ON SECRETIONS, ARTERIAL OXYGENATION, AND OLFACTION - A QUANTITATIVE-EVALUATION

Tracheostomy speaking valves consist of a one-way valve that closes up on exhalation, causing a redirection of exhaled gas into the upper air way, thus allowing for the primary benefit of speech. The present stud y was undertaken to test various hypotheses concerning the secondary b enefits of speaking valves. We hypothesized that use of a speaking val ve will result in a decrease in accumulated secretions, an increase in arterial oxygenation and an improvement in olfactory function. A tota l of 8 tracheotomized patients met the following inclusion criteria: a ge > 18; ability to tolerate wearing a speaking valve for at least 3 h ours; no unstable medical conditions; no use of thrombolytic agents. W hile using the speaking valve patients accumulated fewer secretions (7 4.3 +/- 63.6 vs. 122.8 +/- 44.6 ml/day, p = 0.004, n = 7) and had impr oved olfactory function (accuracy = 28.4 +/- 5.2 vs. 8.1 +/- 2.9%, p = 0.02; and percent correct = 64.2 +/- 2.6 vs. 50.0 +/- 3.9%, p = 0.03, n = 6) than when off the speaking valve. No significant differences w ere found in 24-hour arterial oxygen saturation (pulse oximetry and AB G analysis respectively, n = 7), arterial PO2, pH, PCO2, HCO3, or 24-h our heart rate (n = 7). Thus, the present study found a significant de crease in secretions and improvements in olfaction when tracheotomized patients wore a speaking valve, but no difference in arterial oxygena tion.