What is a Passy-Muir® Valve?
What is a Passy-Muir® Valve?
Invented by a patient named David Muir, the Passy-Muir® Valve is a simple medical device used by tracheostomy and ventilator patients. When placed on the hub of the tracheostomy tube or in-line with the ventilator circuit, the Passy-Muir Valve redirects air flow through the vocal folds, mouth and nose enabling voice and improved communication. Years of evidence-based research has shown that the Passy-Muir Valve offers patients numerous clinical benefits beyond communication, including improved swallowing, secretion management, and oxygenation.
Why use a Passy-Muir Valve?
The patented "No Leak" design of the Passy-Muir® Valves means that the valve is always in a closed position until the patient inhales. The valve opens easily with less than normal inspiratory pressures and closes automatically at the end of the inspiratory cycle without air leak and without patient expiratory effort.
Unlike open position speaking valves, the closed position of the Passy-Muir Valve allows the patient to create a positive airway pressure and restores the patient to a more normal "closed respiratory system". The "closed system" also creates a protective column of air in the tracheostomy tube which resists secretions from moving up the tube and occluding the valve. Instead, secretions may be coughed up around the tube and expectorated or suctioned from the mouth.
The Passy-Muir® Valves are the only speaking valves that have been research validated for all of the following benefits:
- Restores Positive Airway Pressure: Due to the closed position "No Leak" design of the Passy-Muir Valves and the more normal closed respiratory system it creates, positive airway pressure is restored. This in turn promotes louder voice, improved swallow, stronger cough, and increased oxygenation.
- Superior Voice/Speech Production: Patients can produce clearer voice with more normal phrasing, better vocal quality and increased volume because all exhaled airflow is redirected up past the vocal cords.
- Improves Swallow & May Reduce Aspiration: The closed position "No Leak" design of the Passy-Muir Valves restores the patient to more normal physiology. This design facilitates increased pharyngeal/ laryngeal sensation and restores subglottic air pressures which improves swallow and may reduce aspiration.
Video Fluoroscopy without Passy-Muir® Valve: Aspiration
Video Fluoroscopy with Passy-Muir® Valve: No Aspiration
FEES study, by Liza Blumenfeld, MS, CCC-SLP, Scripps Memorial Hospital, La Jolla, CA
- In-Line Ventilator Use: Adult, pediatric and neonatal ventilator dependent patients can utilize the Passy-Muir Valve during mechanical ventilation. All Passy-Muir Valves are interchangeable and can be used both on or off acute care and portable ventilators.
- Expedites Weaning: The Passy-Muir Valves are used as an augmentative tool for weaning patients from the ventilator as it reestablishes physiologic PEEP, which in turn may improve oxygenation. As the patient becomes accustomed to exhaling through the upper airway, patient confidence is improved and respiratory muscle retraining is facilitated.
- Reduces Decannulation Time: The Passy-Muir Valves can be utilized as an interim step in the 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 and can significantly shorten the decannulation process.
- Improves Oxygenation: The closed position "No Leak" design of the Passy-Muir Valves restores a more normal closed respiratory system. As a result, Positive End Expiratory Pressure (PEEP) is reestablished which facilitates improved oxygenation.
- Improves Olfaction: The Passy-Muir Valves improve the sense of smell by reestablishing airflow through the oral/nasal cavities during exhalation. This improved sense of smell may lead to an increase in sense of taste, appetite, and caloric intake which is important in the recovery process.
- Facilitates Secretion Management: The Passy-Muir Valve design improves swallowing and facilitates a stronger, more effective cough with oral expectoration of secretions. Evaporation of secretions occurs due to redirection of air through the upper airway during exhalation. May reduce suctioning needs and associated costs by restoring function of the bronchial hygiene system.
- Facilitates Infection Control: The Passy-Muir Valve eliminates the need for finger occlusion of the tracheostomy tube which can lead to infections and offers protection from particulates entering the trachea. The Passy-Muir Valves redirect secretions through the upper airway allowing oral expectoration and reducing contamination of the patient's immediate environment.
- Interchangeability Between Tracheostomy and Ventilator Use: All Passy-Muir Valves can be used both on and off the ventilator with both pediatric and adult patients. This includes non-ventilator dependent tracheostomized patients, patients who are weaning from the ventilator and patients who are ventilator dependent. The Passy-Muir Valves can be placed in-line with the ventilator using disposable tubing (with PMV® 007 only) or non-disposable flexible rubber tubing (with PMV® 005, PMV® 007, PMV® 2000 and PMV® 2001).