Document Detail

Ventilator-assisted patient vocalization with positive end-expiratory pressure and tracheostomy cuff leak: a brief report.
MedLine Citation:
PMID:  1447005     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To enable vocalization in a tracheostomized ventilator-assisted patient without compromising pulmonary status. DESIGN: Case report. SETTING: University-affiliated nonprofit hospital. PATIENT: A 62-year-old man with a medical history of metastatic lung cancer and chronic obstructive pulmonary disease received mechanical ventilation for 24 days. On the twenty-first day of ventilation the patient requested in writing the desire to vocalize with his family. INTERVENTION: Flow-generated positive end-expiratory pressure of +3 cm of water (PEEP of 3 cm H2O) was applied to the patient's airway and the tracheostomy cuff was slowly deflated to create a cuff leak. The patient was instructed to phonate the letter /a/ until the sound became audible. Lack of voice intensity necessitated PEEP titration of 1 cm H2O increments until 8 cm H2O of PEEP intensified the voice. CONCLUSION: During each session, the patient was able to vocalize clearly, without complications, as measured by the physiologic parameters: heart rate, respiratory rate, blood pressure, and oxygen saturation determined by oximetry.
F Austan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart & lung : the journal of critical care     Volume:  21     ISSN:  0147-9563     ISO Abbreviation:  Heart Lung     Publication Date:    1992 Nov-Dec
Date Detail:
Created Date:  1992-12-30     Completed Date:  1992-12-30     Revised Date:  2006-08-28    
Medline Journal Info:
Nlm Unique ID:  0330057     Medline TA:  Heart Lung     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  575-7     Citation Subset:  AIM; IM    
University of Medicine and Dentistry of New Jersey, Respiratory Care Program, Camden.
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MeSH Terms
Lung Diseases, Obstructive / therapy
Lung Neoplasms / therapy
Middle Aged
Positive-Pressure Respiration / instrumentation,  methods*
Tracheostomy / instrumentation,  methods*
Ventilator Weaning / methods

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