Effect of speaking valve use on decannulation in tracheostomized patients

This study investigates the impact of speaking valve use, in addition to routine treatment and rehabilitation, on decannulation outcomes and related physiological functions in tracheostomized patients. This retrospective cohort study included adult inpatients who underwent tracheostomy from January 2023 to September 2025. Patients were divided into 2 groups based on whether they used a speaking valve. Propensity score matching was applied to control confounding factors, and 80 patients were ultimately included (40 in each group). Baseline data, primary outcomes (decannulation time, success rate, and 72-hour reintubation rate), and secondary outcomes (swallowing function, airway protection, diaphragmatic function, and respiratory physiological parameters) were collected. After matching, baseline characteristics were balanced between the 2 groups (all P > .05). The speaking valve group had a shorter time to decannulation than the nonspeaking valve group (15.5 [11.0-21.0] days vs 21.0 [16.0-28.5] days; unadjusted P = .008, Bonferroni-adjusted P = .024). The speaking valve group also showed a numerically higher successful decannulation rate (85.0% vs 62.5%; unadjusted P = .034, adjusted P = .102) and a numerically lower 72-hour reintubation rate (7.5% vs 25.0%; unadjusted P = .041, adjusted P = .123), although these differences did not remain statistically significant after Bonferroni correction. Secondary outcomes showed that the speaking valve group demonstrated greater improvements in swallowing function, airway protection, diaphragmatic function, and respiratory physiological parameters. In tracheostomized patients, speaking valve use was associated with a shorter time to decannulation and improvements in swallowing function, airway protection, diaphragmatic function, and respiratory physiology. Favorable numerical trends were also observed in successful decannulation and 72-hour reintubation rates, although these differences were not statistically significant after correction for multiple comparisons. Prospective randomized studies are needed to confirm whether speaking valve use improves these clinical outcomes.