Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study

Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study Bin Zhang, Qing Li, Mingna Li, Hao Wang, Jianan Shen, Qian Liu, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4506438/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: The aim of this study was to assess the impact of speaking valve (SV) on ventilation changes, spontaneous effort and their potential effectiveness in difficult-to-decannulate patients with diverse medical conditions. Methods:Patients with prolonged tracheostomy were included, who had been weaned from a ventilator for more than 48 hours, clinically stable and tolerance to the SV. Wearing time of the SV was extended continuously for 4 hours. Electrical impedance tomography (EIT) measurements were conducted at three time points: Tbaseline: prior to the SVs wearing; TSV ~ 3.5 hours after wearing the SVs; Tpost: 10 minutes after removal of SVs after a 4-hour SVs usage. Results: A total of 102 patients were included for the final analysis. No adverse event was recorded in ECG. Oxygenation and respiratory rate were stable. Ventilation distribution was homogeneous in some patients but not in the other after 3.5 hours SV training. Ventilation distributed towards dorsal regions during SV (p<0.001). As spontaneous effort increased during SV, EIT-derived pendelluft increased in most of the patients as well (p<0.001). The correlations between the days to decannulation and the change of EIT-based parameters were significantly correlated (p<0.001). The highest correlations were between Days and temporal ventilation heterogeneity indices (r=0.61 and 0.57, intra-tidal gas distribution and pendelluft, respectively, p<0.001). Conclusion: SV activated patients’ respiratory muscles by increasing the ventilation distribution portions in the dorsal regions, as well as introducing the temporal heterogeneity between ventral and dorsal regions. Such heterogeneity was associated with the day to decannulation. Health sciences/Diseases/Infectious diseases Health sciences/Diseases/Respiratory tract diseases speaking valve tracheostomy electrical impedance tomography spontaneous efforts Full Text Additional Declarations Competing interest reported. Zhanqi Zhao receives consultant fee from Draeger Medical. Other authors declare no conflict of interest. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4506438","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":315914716,"identity":"7d82d3f8-0531-41a8-b74e-639aeeb9845a","order_by":0,"name":"Bin Zhang","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Bin","middleName":"","lastName":"Zhang","suffix":""},{"id":315914717,"identity":"1d3bb85f-203f-4374-9523-da1db548d616","order_by":1,"name":"Qing Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+0lEQVRIie3QMWrDMBSA4WceKItarRaUnkEl0LQQkqs8EfCUI7SJIKDJB0hukal0lDEki2lXQ5aGXsDe3K0idOgkZwxE/yBheB+SDBCLXWC36BcCuGeI+466MRfChImfPJGhGFhKj3l2J9euhwCedr3JKyW/WDlWhnrIQJTN8f012dYZKeKfXIFLmnYevBhLdbVHVc8c0dOBj9Cg3LyFCWi7Y8qf4ogf+LNxDG/CBBtPuKrnD4bYB1eOegmk2r6kMq+GQMydRR49ccr/5Ax0PuNyXayCbxGi+G5/7GJpEXdJ102mQqyKpg2Qv8r/H4npnfctzhmKxWKxa+0X34RPyXEkd7sAAAAASUVORK5CYII=","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":true,"prefix":"","firstName":"Qing","middleName":"","lastName":"Li","suffix":""},{"id":315914718,"identity":"7f176bf5-ac66-43b7-924b-6af62a5674d7","order_by":2,"name":"Mingna Li","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Mingna","middleName":"","lastName":"Li","suffix":""},{"id":315914719,"identity":"b486638c-9264-4b77-9562-474cf3107a9e","order_by":3,"name":"Hao Wang","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Hao","middleName":"","lastName":"Wang","suffix":""},{"id":315914720,"identity":"974dd3ed-8bf4-440e-91d6-065bee209ff4","order_by":4,"name":"Jianan Shen","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jianan","middleName":"","lastName":"Shen","suffix":""},{"id":315914721,"identity":"a8e3d587-3cde-4633-ba55-a149e649971c","order_by":5,"name":"Qian Liu","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qian","middleName":"","lastName":"Liu","suffix":""},{"id":315914722,"identity":"3b7d5478-1967-42b6-b5d3-74a8caa8041d","order_by":6,"name":"Jia Deng","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jia","middleName":"","lastName":"Deng","suffix":""},{"id":315914725,"identity":"bd888b02-09bb-419f-aad2-50cc8c0522ed","order_by":7,"name":"Hongying Jiang","email":"","orcid":"","institution":"Beijing Rehabilitation Hospital of Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Hongying","middleName":"","lastName":"Jiang","suffix":""},{"id":315914726,"identity":"4facbf4a-9d7b-4c6b-a4a8-0cc0c0e5efeb","order_by":8,"name":"Zhanqi Zhao","email":"","orcid":"","institution":"School of Biomedical Engineering, Guangzhou Medical University, China","correspondingAuthor":false,"prefix":"","firstName":"Zhanqi","middleName":"","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2024-05-31 05:44:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4506438/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4506438/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":64642268,"identity":"9f86f97c-e9f1-4319-848f-96aa1985dba9","added_by":"auto","created_at":"2024-09-17 02:44:35","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":577527,"visible":true,"origin":"","legend":"","description":"","filename":"Pendelluftin...speakingvalve202405131.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4506438/v1_covered_daddba98-9832-4dbc-88ba-8ebf307aef78.pdf"}],"financialInterests":"Competing interest reported. Zhanqi Zhao receives consultant fee from Draeger Medical. Other authors declare no conflict of interest.","formattedTitle":"Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"speaking valve, tracheostomy, electrical impedance tomography, spontaneous efforts","lastPublishedDoi":"10.21203/rs.3.rs-4506438/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4506438/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eObjective: The aim of this study was to assess the impact of speaking valve (SV) on ventilation changes, spontaneous effort and their potential effectiveness in difficult-to-decannulate patients with diverse medical conditions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods:Patients with prolonged tracheostomy were included, who had been weaned from a ventilator for more than 48 hours, clinically stable and tolerance to the SV. Wearing time of the SV was extended continuously for 4 hours. Electrical impedance tomography (EIT) measurements were conducted at three time points: Tbaseline: prior to the SVs wearing; TSV ~ 3.5 hours after wearing the SVs; Tpost: 10 minutes after removal of SVs after a 4-hour SVs usage.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: A total of 102 patients were included for the final analysis. No adverse event was recorded in ECG. Oxygenation and respiratory rate were stable. Ventilation distribution was homogeneous in some patients but not in the other after 3.5 hours SV training. Ventilation distributed towards dorsal regions during SV (p\u0026lt;0.001). As spontaneous effort increased during SV, EIT-derived pendelluft increased in most of the patients as well (p\u0026lt;0.001). The correlations between the days to decannulation and the change of EIT-based parameters were significantly correlated (p\u0026lt;0.001). The highest correlations were between Days and temporal ventilation heterogeneity indices (r=0.61 and 0.57, intra-tidal gas distribution and pendelluft, respectively, p\u0026lt;0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: SV activated patients’ respiratory muscles by increasing the ventilation distribution portions in the dorsal regions, as well as introducing the temporal heterogeneity between ventral and dorsal regions. Such heterogeneity was associated with the day to decannulation.\u003c/p\u003e","manuscriptTitle":"Pendelluft in prolonged tracheostomized patients with speaking valve is associated with the time to decannulation：a pre-post study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-20 19:52:05","doi":"10.21203/rs.3.rs-4506438/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"14499078-4454-427a-abb5-5044dc951632","owner":[],"postedDate":"June 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":33407934,"name":"Health sciences/Diseases/Infectious diseases"},{"id":33407935,"name":"Health sciences/Diseases/Respiratory tract diseases"}],"tags":[],"updatedAt":"2024-09-17T02:36:27+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-20 19:52:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4506438","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4506438","identity":"rs-4506438","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}