In my last post, I discussed the Passy-Muir valve, which allows patients who have a tracheostomy tube in place, and are not on a ventilator, to talk. But what about patients who are still vent dependent? It’s very frustrating for both patient and trauma professionals when we can’t communicate with each other.
Pulmodyne, Inc. makes the Blom tracheostomy tube system, which solves this problem. This device has a large fenestration in the back of the tube with a special bubble valve (see below), coupled with an inner cannula that has a 1-way flap valve. This allows controlled release of air into the pharynx, enabling speech while on the ventilator.
A multicenter study looked at voice production and intelligibility of speech in a group of 23 ventilated patients with a trach tube in place. Although not entirely clear in the paper, it appears that all were changed to Blom trach tubes for the study (2 had one in place at the beginning of the study). Overall, voice production and intelligibility were good. Most were able to begin audible speech within about 6 minutes of initial application. One deconditioned patient took longer. The video below shows an example of the speech that is achievable.
Bottom line: This novel product allows a subset of trauma patients to speak while still on the ventilator. It is most appropriate for those who do not have significant head injury, especially those with facial trauma requiring airway protection with a tracheostomy.
I have no financial interest in Pulmodyne, Inc.