Passy-Muir Tracheostomy and Ventilator Swallowing and Speaking Valve

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• Closed Position "No Leak" Design: Restores a more normal closed respiratory system which allows the patient to create positive airway pressure without the need for manual occlusion of the tracheostomy tube.
• Speech: Tracheostomized and ventilator dependent patients can produce clearer speech with more normal phrasing, better vocal quality and increased volume. This allows for normal development of speech and language in children.
• Swallowing: Use of the PMV can improve the safety and efficiency of swallowing and may reduce aspiration. A closed position valve restores the patient to a more normal closed system which facilitates increased pharyngeal or laryngeal sensation and restores positive subglottic air pressure.
• Secretion Management: The closed position no leak design of the PMV facilitates secretion management as it re-establishes a closed system that enables the patient to produce a stronger, more effective cough and improves swallowing due to restored positive subglottic pressure. It also facilitates evaporation of secretions due to redirection of air through the upper airway during exhalation. As a result, suctioning needs may be reduced.
• Weaning: The PMV can be used as an augmentative tool for weaning patients from mechanical ventilation. The closed position no leak design re-establishes a more normal closed respiratory system which restores physiologic PEEP, which can improve oxygenation. As the patient becomes accustomed to exhaling through the upper airway, patient confidence is improved and respiratory muscle retraining is facilitated.
• Decannulation: The PMV can be used as an alternative to tracheal tube plugging for patients who cannot tolerate plugging due to physiologic or emotional reasons. If a patient is tolerating plugging for only short periods of time, the PMV can be used in the interim (between plugging trials) as a step to assist the patient transition from an open tracheostomy tube to tracheal plugging. The PMV assists in the tracheostomy decannulation process by allowing the patient to begin to adjust to a more normal breathing pattern through the upper airway on exhalation. This allows the patient to gain confidence and the physician to assess for airway patency.
• Olfaction: The PMV can improve the sense of smell by re-establishing airflow through the oral or nasal cavities during exhalation. This improved sense of smell may lead to an increase in sense of taste, appetite and caloric intake.
• Hygiene: The PMV facilitates improved tracheal hygiene. This is due to the elimination of the need for manual or finger occlusion of the tracheostomy tube which can lead to infections. The PMV also acts as a filter to prevent particulates from entering the trachea. Secretions are redirected through the upper airway allowing oral expectoration and reducing contamination of the environment.
• Ventilator Use: Can be used interchangeably on or off the ventilator with adult, pediatric and neonatal patients.
• Contraindications:
  - Unconscious or comatose patients
  - Inflated tracheostomy tube cuff
  - Foam filled cuffed tracheostomy tube
  - Severe airway obstruction which may prevent sufficient exhalation
  - Thick and copious secretions
  - severely reduced lung Eeasticity that may cause air trapping
  - This device is not intended for use with endotracheal tubes

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