Patients requiring a tracheostomy tube and mechanical ventilation often face communication barriers due to the inflated tracheostomy tube cuff. An inflated cuff prevents airflow through the vocal cords resulting in the inability to produce audible voice. This lack of airflow in the upper airway can also lead to sensorimotor dysfunction contributing to difficulty with secretion management and swallowing. Above Cuff Vocalization is a promising method to address these challenges.1-3
The Impact of ACV on Quality of Life in Patients with Tracheostomies
Above Cuff Vocalization (ACV) has shown to improve verbal communication with 50-80% of patients achieving audible phonation. 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
Subglottic suction tracheostomy tube
To achieve ACV, a tracheostomy tube with a subglottic suction channel is required. This subglottic suction channel can be used to remove secretions above the cuff which minimizes the risk of bacterially contaminated secretions entering the lower respiratory tract. For this reason, subglottic suctioning is recommended as a preventative measure for ventilator-associated pneumonia.10,11
The ACV procedure
Above Cuff Vocalization involves the controlled application of airflow directed through the subglottic port of a tracheostomy tube. This airflow travels through the upper airway restoring audible voice.
Tracoe Extract Tubes for ACV
The Tracoe Extract tubes are approved for Above Cuff Vocalization (ACV). Tracoe Twist Extract and Tracoe Twist Plus Extract tubes feature an innovative design with a flat, subglottic suction channel that can be connected to a suction port to effectively remove secretions that pool above the cuff. This advanced suction channel delivers significantly improved performance compared to the predecessor model, due to its larger flow cross-section and two strategically located suction points. As a result, secretions are suctioned more rapidly and thoroughly, ensuring enhanced efficiency.
Always consult the products IFU before initiating ACV to ensure alignment with specific instructions for patient selection and delivery.