Using a speaking valve to facilitate weaning from mechanical ventilation in a chronically critically ill patient
A Case Report
Abstract
Introduction: Weaning from Invasive Mechanical Ventilation (IMV) may be delayed or even fail due to multiple reasons, such as patients’ anxiety, anguish and fear, which may negatively impact on the weaning process. We aim to show that the use of a speaking valve in a patient who failed weaning due to anxiety is a useful tool that facilitates weaning.
Case presentation: A 53-year-old female, with a history of heart failure, cardiogenic shock due to aortic valve
infective endocarditis, presented to the hospital and received a valve replacement. She evolved with sepsis, acute renal dysfunction and hemoperitoneum. When admitted to the weaning center, the patient was fully conscious, tracheostomized, and dependent on IMV with critical illness polyneuropathy. After multiple consecutive failures of Spontaneous Breathing Trials (SBTs) using a T-tube due to the patient’s anxiety, we decided to add a speaking valve during the SBT and enable oral communication, which could reduce her anxiety.
Conclusion: The use of a speaking valve could have positively influenced the process of weaning from IMV by
reducing our patient’s anxiety levels.
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