Speech production during mechanical ventilation in tracheostomized individuals

This investigation provides the first detailed description of speech production during mechanical ventilation. Seven adults with tracheostomies served as subjects. Recordings were made of chest wall motions, neck muscle activity, tracheal pressure, air flow at the nose and mouth, estimated blood-gas levels, and the acoustic speech signal during performance of a variety of speech tasks. Results indicated that subjects spoke for short durations that spanned all phases of the ventilator cycle, altered laryngeal opposing pressures in response to the continually changing tracheal pressure wave, and expended relatively small volumes of gas for speech production. Speech was improved by making selected ventilator adjustments. Suggestions for clinical interventions are offered.