Effect of speaking valves on early mobilization of patients in intensive care units following tracheostomy: a prospective randomized controlled trial.

OBJECTIVES

To evaluate the effect of Speaking Valves (SVs) on early mobilization in Intensive Care Unit (ICU) patients following tracheostomy.

METHODS

The participants of this study were patients undergoing tracheotomy who were admitted to ICU of The First Affiliated Hospital of Ningbo University from December 2020 to June 2023. Patients were divided into a test group (n = 47) and a control group (n = 43) based on the random number table method. Further comparison was made on the five-level EuroQol five-Dimensional Questionnaire (EQ-5D-5L) score, swallowing function grading, mobility score, and adverse reactions.

RESULTS

The experimental group demonstrated significantly greater improvement in the primary outcome of mobility assessed by Chelsea Critical Care Physical Assessment Tool (CPAx) (median [IQR] at day-21: 28.0 [25.0‒30.0] vs. control: 22.0 [20.0‒25.0], p < 0.001). The experimental group showed greater improvements in secondary outcomes: EuroQol Visual Analogue Scale (EQ-VAS) (control: 72.40 ± 17.23 to 79.70 ± 11.40; experimental: 73.10 ± 15.23 to 92.34 ± 11.78; p < 0.001), EuroQol five-Dimensional (EQ-5D) scores (control: 0.80 ± 0.21 to 0.90 ± 0.14; experimental: 0.81 ± 0.14 to 0.94 ± 0.13; p < 0.001), and swallowing function grading (control: median 5.00 to 4.00; experimental: 5.00 to 2.00; p < 0.001) following rehabilitation.

CONCLUSION

The addition of SVs to standard rehabilitation significantly enhanced early mobilization, respiratory function and coughing capacity in patients with tracheostomy. These findings support incorporating SVs into ICU care protocols to prioritize early mobilization, potentially shortening hospital stays and improving functional outcomes.

LEVEL OF EVIDENCE: Level 3.