Evaluation of a Tracheostomy Tube That Enables Communication

NCT ID: NCT02018562

Last Updated: 2024-09-19

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-28

Study Completion Date

2017-05-21

Brief Summary

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Verbal communication is vital to critically ill mechanically ventilated patient's quality of life (Hess, 2005). Patients who have a tracheostomy tube may be able to communicate using a speaking valve, however, some patients may not be able to tolerate cuff deflation for use of speaking valve. There are talking tracheostomy tubes that do not require cuff deflation to facilitate speech in this population. Unfortunately, not all candidates are offered these options due to lack of awareness. Recently, at our institution, there has been an increase in the use of these tubes to facilitate speech. One of the talking tracheotomy tubes that has proven to be effective is the Portex Blueline Ultra Suctionaid (BLUSA).

In 2010, we conducted a retrospective review of 4 cases and found that BLUSA tracheostomy helped facilitate communication in this unique population (IRB #: NA\_00041547). We would now like to formally conduct a prospective pilot study to evaluate the feasibility of measuring outcomes of patients with a BLUSA using a pretest-posttest research design.

Communication empowers patients and allows healthcare staff to obtain a more accurate assessment of patients' condition and tailor care accordingly. Identifying the predictors of speech intelligibility and the impact of BLUSA on quality of life will promote communication between patients and healthcare providers.

Study Hypothesis: Determine the impact of a talking tracheostomy tube on quality of life in patients requiring prolonged mechanical ventilation in the hospital.

Detailed Description

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Conditions

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Evaluate the Effect of a Talking Tracheostomy Tube on Quality of Life

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Unable to mask because patients and care providers were able to visualize the type of tracheostomy tub that was used.

Study Groups

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Intervention

1. The talking tracheostomy trial involves placement of a talking tracheostomy tube (Portex Blueline Ultra Suctionaid Tracheostomy Tube) by respiratory therapist after obtaining an order from an authorized prescriber (Physician or Nurse Practitioner). The Speech-Language Pathologist (SLP) sets up the tracheostomy tube for speech and then determines the optimal air flow required for voicing. This amount of air flow is communicated to the ICU staff for further use.
2. We will ensure that the SLP meets with the patient for a minimum of 3 sessions within a week to optimize the use of a talking tracheostomy tube.

i. SLP will also assess the duration of successful speech during each session

ii. Sentence intelligibility will also be assessed during the 3rd session. This session will be audio-taped and reviewed by a second rater for sentence intelligibility.

iii. SLP will determine the level of independence with talking tracheostomy during the 3rd session.

Group Type EXPERIMENTAL

Portex Blueline Ultra Suctionaid Tracheostomy Tube

Intervention Type DEVICE

Control

This group will also receive talking tracheostomy tube trial as standard of care but a week later after the pre and post assessments have been completed

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Portex Blueline Ultra Suctionaid Tracheostomy Tube

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Mechanically ventilated via tracheostomy
* Awake, alert, and attempting to communicate
* Able to understand English

Exclusion Criteria

* Delirium
* Fresh tracheostomy within 48 hours
* Laryngectomy
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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The Johns Hopkins Hospital

Baltimore, Maryland, United States

Site Status

Countries

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United States

References

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Batty S. Communication, swallowing and feeding in the intensive care unit patient. Nurs Crit Care. 2009 Jul-Aug;14(4):175-9. doi: 10.1111/j.1478-5153.2009.00332.x.

Reference Type BACKGROUND
PMID: 19531034 (View on PubMed)

Frost SA, Azeem A, Alexandrou E, Tam V, Murphy JK, Hunt L, O'Regan W, Hillman KM. Subglottic secretion drainage for preventing ventilator associated pneumonia: a meta-analysis. Aust Crit Care. 2013 Nov;26(4):180-8. doi: 10.1016/j.aucc.2013.03.003. Epub 2013 Apr 11.

Reference Type BACKGROUND
PMID: 23583261 (View on PubMed)

Hess DR. Facilitating speech in the patient with a tracheostomy. Respir Care. 2005 Apr;50(4):519-25.

Reference Type BACKGROUND
PMID: 15807915 (View on PubMed)

Husain T, Gatward JJ, Harris RD. Use of subglottic suction port to enable verbal communication in ventilator-dependent patients. Am J Respir Crit Care Med. 2011 Aug 1;184(3):384. doi: 10.1164/ajrccm.184.3.384. No abstract available.

Reference Type BACKGROUND
PMID: 21804129 (View on PubMed)

Coffman HM, Rees CJ, Sievers AE, Belafsky PC. Proximal suction tracheotomy tube reduces aspiration volume. Otolaryngol Head Neck Surg. 2008 Apr;138(4):441-5. doi: 10.1016/j.otohns.2007.11.013.

Reference Type RESULT
PMID: 18359351 (View on PubMed)

Hofhuis JG, Spronk PE, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J. Experiences of critically ill patients in the ICU. Intensive Crit Care Nurs. 2008 Oct;24(5):300-13. doi: 10.1016/j.iccn.2008.03.004. Epub 2008 May 9.

Reference Type RESULT
PMID: 18472265 (View on PubMed)

Lacherade JC, De Jonghe B, Guezennec P, Debbat K, Hayon J, Monsel A, Fangio P, Appere de Vecchi C, Ramaut C, Outin H, Bastuji-Garin S. Intermittent subglottic secretion drainage and ventilator-associated pneumonia: a multicenter trial. Am J Respir Crit Care Med. 2010 Oct 1;182(7):910-7. doi: 10.1164/rccm.200906-0838OC. Epub 2010 Jun 3.

Reference Type RESULT
PMID: 20522796 (View on PubMed)

Nomori H. Tracheostomy tube enabling speech during mechanical ventilation. Chest. 2004 Mar;125(3):1046-51. doi: 10.1378/chest.125.3.1046.

Reference Type RESULT
PMID: 15006967 (View on PubMed)

Pandian V, Maragos C, Turner L, Mirski M, Bhatti N, Joyner K. Model for best practice: nurse practitioner facilitated percutaneous tracheostomy service. ORL Head Neck Nurs. 2011 Spring;29(2):8-15.

Reference Type RESULT
PMID: 21675700 (View on PubMed)

Pandian V, Miller CR, Mirski MA, Schiavi AJ, Morad AH, Vaswani RS, Kalmar CL, Feller-Kopman DJ, Haut ER, Yarmus LB, Bhatti NI. Multidisciplinary team approach in the management of tracheostomy patients. Otolaryngol Head Neck Surg. 2012 Oct;147(4):684-91. doi: 10.1177/0194599812449995. Epub 2012 Jun 5.

Reference Type RESULT
PMID: 22675004 (View on PubMed)

Pandian V, Cole T, Kilonsky D, Holden K, Feller-Kopman DJ, Brower R, Mirski M. Voice-Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial. Laryngoscope. 2020 May;130(5):1249-1255. doi: 10.1002/lary.28211. Epub 2019 Aug 6.

Reference Type DERIVED
PMID: 31385620 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NA_00086689

Identifier Type: -

Identifier Source: org_study_id

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