Passy-Muir valve in children with tracheotomy

Introduction: Early vocalization and speech production remains a goal in children who require tracheotomy for airway obstruction or chronic ventilation. Although studies document the efficacy of the Passy-Muir valve (PMV) in adults, none have reviewed its efficacy in children. We performed this study to better understand the clinical complexity of its use in children. Materials and methods: Retrospective evaluation of 55 consecutive cases of children with tracheotomy using the PMV. Results: The children ranged in age from 3 days to 18 years at the time of their tracheotomies, and nearly half were 12 months old or younger. Successful use often requires patient and family conditioning. Overall, 52 children out of the 55 who were evaluated as candidates for the PMV tolerated its use. Many required two or more trials prior to the patient and family being comfortable with its use. Conclusions: The PMV may be used successfully in children with a variety of airway pathologies as well as diverse medical problems. Discussed is the current protocol for the evaluation of the patient and the introduction of the valve. Copyright (C) 1999 Elsevier Science Ireland Ltd.