Simple Adjustments Can Improve Ventilator-Supported Speech Six subjects who were tracheostomized and chronically ventilator-supported because of neuromuscular disease or injury were studied to determine if their speech could be improved. Using subjects’ own portable ventilators, adjustments were made that reduced inspiratory flow and added positive end-expiratory pressure (PEEP). These adjustments resulted in increases in speaking time ... Research Article
Research Article  |   February 01, 1997
Simple Adjustments Can Improve Ventilator-Supported Speech
 
Author Affiliations & Notes
  • Jeannette D. Hoit
    National Center for Neurogenic Communication Disorders University of Arizona, Tucson Brockton/West Roxbury U.S. Department of Veterans Affairs Medical Center, Boston, MA
  • Robert B. Banzett
    Harvard Medical School, Boston, MA Physiology Program, Harvard School of Public Health Brockton/West Roxbury U.S. Department of Veterans Affairs Medical Center, Boston, MA
  • Contact author: Jeannette D. Hoit, Department of Speech and Hearing Sciences, P.O. Box 210071, University of Arizona, Tucson, Arizona 85721
    Contact author: Jeannette D. Hoit, Department of Speech and Hearing Sciences, P.O. Box 210071, University of Arizona, Tucson, Arizona 85721×
  • Corresponding author: Email: jenjen@cnet.shs.arizona.edu
Article Information
Research Articles
Research Article   |   February 01, 1997
Simple Adjustments Can Improve Ventilator-Supported Speech
American Journal of Speech-Language Pathology, February 1997, Vol. 6, 87-96. doi:10.1044/1058-0360.0601.87
History: Received July 16, 1996 , Accepted November 13, 1996
 
American Journal of Speech-Language Pathology, February 1997, Vol. 6, 87-96. doi:10.1044/1058-0360.0601.87
History: Received July 16, 1996; Accepted November 13, 1996

Six subjects who were tracheostomized and chronically ventilator-supported because of neuromuscular disease or injury were studied to determine if their speech could be improved. Using subjects’ own portable ventilators, adjustments were made that reduced inspiratory flow and added positive end-expiratory pressure (PEEP). These adjustments resulted in increases in speaking time per ventilator cycle, increases in number of syllables produced per cycle, and decreases in peak tracheal pressure. Improvements in speech were perceptible to listeners in 3 of the 6 subjects. Listeners preferred speech produced under the ventilator-adjusted condition primarily because the quantity of speech produced per ventilator cycle increased, loudness fluctuation decreased, and voice quality improved. The only subject who showed no perceptible benefit from the adjustments had a substantial air leak around her tracheostomy tube. Importantly, gas exchange was not compromised in any of the subjects. We believe that adjustments such as prolonging inspiration and adding PEEP, when implemented in collaboration with appropriate health-care professionals, represent a simple, inexpensive, and safe intervention for improving speech in certain ventilator-supported individuals.

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