Above-cuff vocalization in tracheostomized adults: a systematic review
Abstract
Objective: To synthesize the effects of above-cuff vocalization (ACV) in tracheostomized adults.
Materials and methods: A systematic review (PROSPERO CRD42023395561) was conducted including randomized controlled trials (RCTs) and cross-over RCTs to synthesize the effects of ACV on decannulation, quality of life (QoL), and adverse events (AEs) in tracheostomized adult subjects.
Results: One study of 50 subjects was included, which did not assess decannulation. ACV showed little or no difference in health- and voice-related QoL at five days of follow-up (mean difference 0.83 and 10.24; confidence interval: -10.3 to 11.96 and -2 to 22.48, respectively), and likely had little or no difference in AEs at two weeks of follow-up (0 per 1000, 0 to 0), with low and moderate certainty, respectively.
Conclusion: There is no evidence on the effect of ACV on decannulation, and the certainty of evidence regarding QoL and AEs is low to moderate. Further research addressing unreported outcomes is required.
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