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Clinical ventilator adjustments that improve speech.

Jeannette D Hoit1, Robert B Banzett, Heather L Lohmeier

  • 1Department of Speech and Hearing Sciences and National Center for Neurogenic Communication DisordersUniversity of Arizona, Tucson, AZ 85721, USA. hoit@email.arizona.edu

Chest
|October 14, 2003
PubMed
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Adjusting ventilator settings like inspiratory time (TI) and positive end-expiratory pressure (PEEP) significantly improves speech for individuals on positive-pressure ventilation, enhancing communication and voice quality.

Area of Science:

  • Respiratory therapy
  • Speech-language pathology
  • Biomedical engineering

Background:

  • Individuals requiring positive-pressure ventilation often experience impaired speech.
  • Common speech deficits include short phrases, prolonged pauses, reduced loudness, and poor voice quality.

Purpose of the Study:

  • To investigate methods for improving speech in tracheostomized individuals on positive-pressure ventilation.
  • To evaluate the impact of specific ventilator adjustments on speech production.

Main Methods:

  • Studied 15 adults with spinal cord injuries or neuromuscular diseases on long-term ventilation.
  • Adjusted ventilator settings including lengthened inspiratory time (TI) and positive end-expiratory pressure (PEEP).
  • Assessed changes in speaking time, pause duration, loudness, and voice quality.

Related Experiment Videos

Main Results:

  • Lengthening TI increased speaking time by 19% and decreased pause time by 12%.
  • Adding PEEP (5-10 cm H2O) increased speaking time by 25% and reduced pauses by 21%.
  • Combined TI and PEEP interventions showed additive effects, increasing speaking time by 55% and reducing pauses by 36%, also improving loudness and voice quality.

Conclusions:

  • Simple ventilator adjustments (TI, PEEP) significantly enhance speech in ventilated individuals.
  • These interventions are safe for short-term use.
  • High PEEP may be a safer alternative to one-way valves for speech.