Are Fenestrated Tracheostomy Tubes Still Valuable?
Vinciya Pandian, Sarah E Boisen, Shifali Mathews and 1 others
PMID 31318610WHAT IT FOUND
Fenestrated tracheostomy tubes were used for speech in this small chart review, but airway complications were also frequent.
The review cannot show that the tube caused either benefit or harm.
Key findings
01Thirteen patients received a fenestrated tracheostomy tube for phonation.
02Of the 13 patients who received a fenestrated tracheostomy tube for phonation, only one was not able to phonate.
03Nine patients developed some type of complication: granulation, tracheomalacia, or tracheal stenosis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a retrospective chart review, so it relied on information already written in medical records. The sample was very small, with only 15 patients who had a fenestrated tracheostomy tube. Only five patients received the fenestrated tube at the study hospital, and several data were not available for outside-hospital patients. There was no comparison group of patients without a fenestrated tube, so the paper cannot separate the tube's effects from the patients' underlying illness, intubation, or tracheostomy care. The authors state that the small sample limits clinical recommendations and generalizability.
Declared interests
Medtronic funded an investigator-initiated grant to Johns Hopkins School of Nursing. Medtronic had no role in project design or execution, but approved the submission without modifying manuscript content. Pandian also reported NIH research grants.
The easy way to misread this
Do not conclude that fenestrated tracheostomy tubes improve speech or cause airway complications. This was a small retrospective chart review with no comparison group without a fenestrated tube, and patients had other airway problems or prolonged intubation, so the tube's contribution cannot be separated.