Comparative Effects of Two Ventilatory Modes on Speech in Tracheostomized Patients with Neuromuscular Disease
| العنوان: | Comparative Effects of Two Ventilatory Modes on Speech in Tracheostomized Patients with Neuromuscular Disease |
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| المؤلفون: | Hélène Prigent, Marie-France Abinun, Frédéric Lofaso, Bruno Louis, Françoise Zerah-Lancner, Jean-Claude Raphaël, Christiane Samuel, Michèle Lejaille |
| المصدر: | American Journal of Respiratory and Critical Care Medicine. 167:114-119 |
| بيانات النشر: | American Thoracic Society, 2003. |
| سنة النشر: | 2003 |
| مصطلحات موضوعية: | Adult, Male, Pulmonary and Respiratory Medicine, Artificial ventilation, Speech production, Respiratory rate, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, Sampling Studies, Positive-Pressure Respiration, Speech Production Measurement, Intensive care, Intubation, Intratracheal, otorhinolaryngologic diseases, Humans, Speech, Medicine, Prospective Studies, Probability, Analysis of Variance, Pulmonary Gas Exchange, business.industry, Speech Intelligibility, Neuromuscular Diseases, Middle Aged, Prognosis, Respiration, Artificial, Respiratory failure, Anesthesia, Respiratory Mechanics, Breathing, Female, Tracheotomy, Respiratory Insufficiency, business |
| الوصف: | Many patients with respiratory failure related to neuromuscular disease receive chronic invasive ventilation through a tracheostomy. Improving quality of life, of which speech is an important component, is a major goal in these patients. We compared the effects on breathing and speech production of assist-control ventilation (ACV) and bilevel positive-pressure ventilation (BPPV) in nine patients with neuromuscular disease. Ventilator-delivered flow was measured using a pneumotachograph, and respiratory rate, inspiratory time, and ventilator-delivered volume were measured on this flow signal. Gas exchange was assessed using oxygen saturation and end-tidal carbon dioxide measurement. Microphone speech recordings were subjected to quantitative analysis. At rest, ventilatory parameters were similar with both modes. Speech induced an increase in inspiratory time during BPPV, with a greater increase in the volume released by the ventilator during speech as compared with ACV (172 +/- 194 versus 26 +/- 31 ml). Consequently, speech duration was longer during inspiration with BPPV. Moreover, BPPV allowed speech production to extend into expiration, and three patients could speak continuously during several respiratory cycles while receiving BPPV. Blood gas exchange was not modified by speech with BPPV or ACV. This study shows that BPPV provides better speech duration than ACV with no detectable short-term deleterious effects. |
| تدمد: | 1535-4970 1073-449X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e2c2855c7a11c2c182e79f53aee12cc1Test https://doi.org/10.1164/rccm.200201-026ocTest |
| رقم الانضمام: | edsair.doi.dedup.....e2c2855c7a11c2c182e79f53aee12cc1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15354970 1073449X |
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