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dc.contributor.authorZaga, Charissa J-
dc.contributor.authorBerney, Susan C-
dc.contributor.authorVogel, Adam P-
dc.identifier.citationAmerican journal of speech-language pathology 2019; 28(3): 1335-1355-
dc.description.abstractPurpose The aim of this study was to conduct a systematic review of the literature relating to the feasibility, utility, and safety of augmentative and alternative communication (AAC) interventions and tracheostomy-related communication interventions with mechanically ventilated adult patients in the intensive care unit (ICU). Method MEDLINE, Embase, and PsycINFO databases were searched for relevant articles. Studies were included if (a) they were performed in the ICU, (b) they involved participants > 18 years of age, (c) > 85% of participants were mechanically ventilated, and (d) they reported on content that related to the feasibility and/or utility and/or safety of AAC intervention and/or tracheostomy-related communication intervention. Studies were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The levels of evidence for included studies were assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Results Forty-eight studies met the inclusion criteria. Different communication interventions relating to intubated and tracheostomized mechanically ventilated patients were reviewed, including (a) communication boards, (b) electrolarynx, (c) high-technology AAC devices, (d) tracheostomy tubes with communication-enabling features, (e) one-way valve in line with the ventilator, (f) ventilator-adjusted leak speech, (g) ventilator adjustments and one-way valve, and (h) multiple interventions. Forty-seven of 48 studies examined the feasibility and utility of the interventions. Sixteen studies examined the safety of the interventions. The included studies were composed of randomized controlled trials (n = 2), quasi-experimental studies (n = 7), cohort studies (n = 8), case-control (n = 1), case series (n = 23), and case reports (n = 7). The levels of evidence varied and ranged from high (n = 2), moderate (n = 7), low (n = 9), and very low (n = 30). Conclusions There is developing evidence that communication interventions with mechanically ventilated ICU patients are feasible, have utility, and are safe. Further research is warranted to guide speech pathologist-directed intervention to improve patient outcomes and the patient experience in the ICU.-
dc.titleThe Feasibility, Utility, and Safety of Communication Interventions With Mechanically Ventilated Intensive Care Unit Patients: A Systematic Review.-
dc.typeJournal Article-
dc.identifier.journaltitleAmerican journal of speech-language pathology-
dc.identifier.affiliationCentre for Neuroscience of Speech, The University of Melbourne, Australiaen
dc.identifier.affiliationRedenlab, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Speech Pathology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tübingen Germanyen
dc.identifier.affiliationTracheostomy Review and Management Service, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Physiotherapy, School of Health Sciences, The University of Melbourne, Australiaen
dc.identifier.affiliationDepartment of Physiotherapy, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Article-, Susan C
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairecristype Pathology- Review and Management Service-
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