{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:37:43Z","timestamp":1781195863333,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Patients in intensive care frequently suffer from not being able to communicate verbally. The aim of this scoping review was to study the safety and effectiveness of the above cuff vocalisation (ACV) on speech and quality of life (QOL) in patients dependent on a cuffed tracheostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A scoping review was conducted. The databases Ovid Medline, Cochrane Library, and Embase were systematically searched in May 2020. We included clinical studies with patients exposed to ACV where speech, QOL or safety issues were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 17 studies were included, of which 15 were observational and 2 were randomised controlled trials. Totally, 231 patients were included. ACV enabled most of the included patients (115\/131; 88%) to speak with an audible voice or whisper (moderate quality of evidence). Voice related QOL (V\u2010RQOL) and QOL in mechanically ventilated patients (QOL\u2010MV) improved from pre\u2010 to post\u2010 ACV compared to a control group not tolerating a one\u2010way speaking valve (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, respectively) (very low quality of evidence). Several minor complications or problems were reported in 20\/75 (27%) cases in addition to two serious adverse events: subcutaneous emphysema in one patient where the tracheostomy was dislodged and a distended trachea in another due to the misconnection of continuous gas to the cuff (low\/ very low quality of evidence).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACV facilitated communication in patients dependent on a cuffed tracheostomy and attempting to communicate. Quality of evidence in improved V\u2010RQOL and QOL\u2010MV was very low. Several minor complications and two serious adverse events were reported.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13706","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T08:00:54Z","timestamp":1600761654000},"page":"15-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Above cuff vocalisation (ACV): A scoping review"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0801-9892","authenticated-orcid":false,"given":"Antonija","family":"Petosic","sequence":"first","affiliation":[{"name":"Division of Emergencies and Critical care Department of Postoperative and Intensive care Oslo University Hospital Oslo Norway"},{"name":"Faculty of Medicine Institute of Health and Society University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit F.","family":"Viravong","sequence":"additional","affiliation":[{"name":"Medical Division Department of Clinical Services, Physiotherapy Service Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Martin","sequence":"additional","affiliation":[{"name":"Medical Division Department for Clinical Services, Speech and Language Therapy Service Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie B.","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical care Department of Postoperative and Intensive care Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell","family":"Olafsen","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical care Department of Anesthesiology Oslo University Hospital Oslo 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