Simple Adjustments Can Improve Ventilator-Supported Speech

Jeannette D. Hoit, Robert B. Banzett

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)87-96
Number of pages10
JournalAmerican journal of speech-language pathology
Volume6
Issue number1
DOIs
StatePublished - Feb 1997

Keywords

  • Mechanical ventilation
  • Neuromuscular disorders
  • Respiratory insufficiency
  • Speech treatment
  • Ventilator dependent

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Developmental and Educational Psychology
  • Linguistics and Language
  • Speech and Hearing

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