Physiological and clinical outcomes associated with use of one-way speaking valves on tracheostomised patients: A systematic review.

BACKGROUND: The one way speaking valve was first engineered in 1985 to allow patients with tracheostomies to communicate. The research has indicated alternative physiological benefits of using a speaking valve, however this literature has not yet been evaluated. The purpose of this systematic review was to evaluate the evidence for one-way speaking valve in a range of physiological domains, including vital signs, aspiration, olfaction, ventilation and tracheostomy weaning, length of stay, and quality of life.

METHODS: A literature search was conducted in September 2017. Studies were eligible if they compared the use of a one-way speaking valve against no speaking valve, across any physiological or clinical parameter.

RESULTS: 16 eligible studies were included in this review. A meta-analysis random-effect model (I2  = 71.96, p = 0.006) found reduced instances of aspiration with a speaking valve in situ, compared to without a speaking valve in situ (OR 0.122; 95% confidence interval, 0.031-0.479; p = 0.003). Statically significant results were also found across the domains of olfaction, secretion management and ventilation.

CONCLUSION: There is emerging evidence of additional benefits for using speaking valves. Further studies should focus on clinical outcomes that have the potential to reduce healthcare costs as well as patient outcomes.