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Study objectives: To compare the effects of early verses standard intervention for return of voice in mechanically ventilated tracheostomy patients.

Methods: A randomised trial of ESI versus standard management for tracheostomy patients was conducted in the ICU at Royal Prince Alfred Hospital, Australia. ESI included cuff deflation and use of the Passy Muir ventilation and speaking valve during mechanical ventilation. Standard management was cuff deflation and use of a Portex-orator speaking valve during self-ventilation. A Speech Pathologist provided all interventions.

Results: Thirty participants were randomly allocated into two equal groups. The primary outcome measure was time from tracheostomy insertion to phonation. ESI significantly hastened return to phonation (median difference= 11 days, Hazard ratio= 3.66, 95% CI= 1.54–8.68). ESI however did not significantly affect duration of tracheostomy …