In the ICU, patients on invasive mechanical ventilation often face communication barriers due to the inflated tracheostomy tube cuff. This cuff, while medically necessary, prevents air from flowing through the larynx and vocal cords, making speech impossible and reducing oropharyngeal sensitivity, which affects swallowing and coughing abilities. Above Cuff Vocalization emerges as a promising method to address this challenge.1-3
The Impact of ACV on Quality of Life in Tracheostomized Patients
Above Cuff Vocalization (ACV) has shown promising results in improving communication for tracheostomized ICU patients, with around 50 to 80% achieving vocalization when cuff deflation is not possible.1-3,8 Studies, including a randomized controlled trial, highlight ACV's safety and benefits, such as successful phonation, enhanced cough and swallow function, and improved quality of life.2-4
The Impact of Subglottic Suction Tubes
Subglottic suction tracheostomy tubes are increasingly used in acute settings to reduce ventilator-associated pneumonia (VAP) and mortality.5-7 These tubes also enable earlier application of Above Cuff Vocalization (ACV)8, addressing both medical and communication needs. This dual approach ensures effective secretion management and allows patients to vocalize, improving their mental and physical well-being.4
The ACV procedure
Above Cuff Vocalization involves the controlled application of a continuous or intermittent airflow directed through the subglottic port of a tracheostomy tube. This airflow traverses the laryngeal anatomy, allowing for vocalization and the potential restoration of oropharyngeal and laryngeal sensation.
Log in or register to access the step-by-step instructional video, guiding you through the application of ACV in ventilated patients. Additionally, you can download a one-page step-by-step guide to provide a reference in clinical practice as well as some Saftey Guidelines.
Tracoe Extract Tubes for ACV
All Tracoe Extract tracheostomy tubes are also approved for utilizing the subglottic suction channel or suction line for Above Cuff Vocalization (ACV). To enable voicing, air and/or oxygen can be introduced through the subglottic suction, directed toward the upper airway through the vocal folds.
Always consult the products IFU before initiating ACV to ensure alignment with specific instructions for patient selection and delivery.