Facilitating Patient Communication During Noninvasive Ventilation

We will conduct a prospective feasibility study to evaluate speech intelligibility of 10 patients (target distribution of gender: 5 males, 5 females) undergoing standard of care, clinically indicated non-invasive ventilation. Patients will be their own control with and without the ReddyPort™ microphone using a crossover design, with the sequence of conditions randomized (half of patients start with microphone turned on, half start with the microphone turned off). The patients in this study will all receive standard of care. No medical decisions for a change in care will result from the speech recordings obtained during this feasibility study. The speech recordings will be analyzed off-site using a pool of blinded volunteers. The microphone on and off test conditions will not be used to change outcome of the clinical course of care.

Inclusion criteria

• Age greater than or equal to 18 years
• Currently hospitalized
• Awake and able to attempt communication
• Respiratory failure requiring non-invasive ventilatory support
• Positive Inspiratory Pressure (PIP) less than or equal to 20 cm H2O
• Positive End Expiratory Pressure (PEEP) less than or equal to 10 cm H2O
• FiO2 less than or equal to 0.60
• Clinical attending physician believes it is safe for the patient to participate
• Able to consent o If patient cannot consent on the basis of difficulty in being heard and asking questions (as in fact may occur with NIV, a key assumption of this study), then assent will be obtained from the patient with informed consent obtained from a legally authorized representative.

Exclusion criteria

• Tachypnea with RR > 35
• Increase in PIP, PEEP or FiO2 over the last 2 hours
• Known to be delirious (clinically obtained CAM score that is positive)
• Prisoner