Luis

Luis received a tracheostomy due to respiratory failure from COPD. He is currently weaned from mechanical ventilation and is receiving 40% fraction of inspired oxygen by a tracheostomy mask. Luis has a cuffless Shiley #6 tracheostomy tube. Since there is no cuff, airflow takes the path of least resistance with some airflow through the tracheostomy tube and a minimal amount of airflow escaping through the upper airway.  Therefore voicing sounds weak and breathy. Luis has to take a deep breath before each word in order to produce voicing. Once Luis places his PMV 2001, all expired air is redirected through the upper airway. You will notice that his voice is stronger and he has uninterrupted speech.