Principles & Practice of Mechanical Ventilation, 2e >Jeannette D. Hoit,  Robert B. Banzett,  Robert Brown

Ventilator-Supported Speech: Introduction

"Under normal circumstances, the respiratory system supplies the aeromechanical drive that allows the vocal folds, tongue, lips, and other structures to create the sounds of speech. Although a simplification, this drive can be understood as the tracheal pressure. Usually this pressure is exquisitely and actively controlled by muscles of the chest wall. When speech is produced with ventilator support, however, the ventilator and the respiratory system must work together to produce the pressure that drives speech production. In most cases, this pressure is markedly different from that of normal speech production. As a result, the act of speaking can be challenging for patients, and they often require assistance from their pulmonologist, respiratory therapist, and speech-language pathologist. The views presented here are that patients should be enabled to speak whenever possible, and that ventilator-supported speech can often be improved by using interventions such as those described in this chapter...."