Garcia-Rodriguez Laura, Miah Tayaba, Lindholm Jamie, Chang Steven, Ghanem Tamer
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Wayne State University, School of Medicine, Detroit, Michigan, USA.
OTO Open. 2017 Feb 3;1(1):2473974X17691223. doi: 10.1177/2473974X17691223. eCollection 2017 Jan-Mar.
We aimed to evaluate the use of an electrocardiogram (EKG) electrode over decannulation dressings covering the stoma to improve speech intelligibility and volume and reduce air escape by facilitating identification of the "sweet spot" of the dressing. No objective data exist for patient outcomes with use of the EKG electrode dressing.
This prospective study included head and neck oncology patients at a tertiary hospital who received a tracheostomy. A standard tracheostomy decannulation dressing was placed followed by an EKG electrode. A speech pathologist evaluated speech volume via sound-level meter and captured speech intelligibility for random sentence-level speech. A blinded reviewer scored speech samples for intelligibility. Patients completed a 4-question satisfaction survey.
Four patients completed the study. Based on the survey, the patients favored the button, with the lowest scores being 8.5 out of 10. Speech understanding was 48.5% without the button and 83% with the button. Normal speech volume was 73.75 dB without the button and 77.75 dB with the button. Loud speech volume was 80.75 dB without the button and 87 dB with the button.
This pilot study shows objective benefits of the EKG button as well as improved patient satisfaction. Inexpensive and low maintenance, the EKG electrode provides better occlusion of stoma dressing with easier localization.
Dissemination of our results will aim to improve quality and patient outcomes following decannulation.
我们旨在评估将心电图（EKG）电极置于覆盖造口的拔管敷料上的效果，以通过协助确定敷料的“最佳位置”来提高语音清晰度和音量，并减少空气逸出。目前尚无关于使用EKG电极敷料的患者结局的客观数据。
这项前瞻性研究纳入了一家三级医院接受气管造口术的头颈肿瘤患者。先放置标准的气管造口拔管敷料，然后再放置一个EKG电极。言语病理学家通过声级计评估语音音量，并采集随机句子水平语音的语音清晰度。一名盲法评审员对语音样本的清晰度进行评分。患者完成了一项包含4个问题的满意度调查。
4名患者完成了研究。根据调查，患者对该按钮较为满意，最低得分为8.5分（满分10分）。不使用按钮时语音理解率为48.5%，使用按钮时为83%。正常语音音量在不使用按钮时为73.75分贝，使用按钮时为77.75分贝。大声语音音量在不使用按钮时为80.75分贝，使用按钮时为87分贝。
这项初步研究显示了EKG按钮的客观益处以及患者满意度的提高。EKG电极价格低廉且维护成本低，能更好地封闭造口敷料，且定位更容易。
传播我们的研究结果旨在提高拔管后的质量和患者结局。
