Using a novel in-mask non-invasive ventilator microphone to improve talker intelligibility in healthy and hospitalised adults

Abstract

Purpose: Non-invasive ventilation (NIV) provides respiratory support without invasive endotracheal intubation but can hinder patients’ ability to communicate effectively. The current study presents preliminary results using a novel in-mask ventilator microphone to enhance talker intelligibility while receiving NIV.

Method: A proof-of-concept study assessed sentence intelligibility of five healthy adult talkers using a prototype model of the microphone under continuous positive airway pressure (CPAP; 5/5 cm H₂O) and bilevel positive airway pressure (BiPAP; 8/4 cm H₂O) ventilator conditions. A pilot study then assessed intelligibility, subjective comprehensibility and naturalness, and patient- and conversation partner-reported communication outcomes for eight patients undergoing therapeutic NIV while being treated in an intensive care unit (ICU).

Result: Intelligibility increased significantly with the microphone on in the BiPAP condition for healthy volunteers. For patients undergoing NIV in an ICU, intelligibility, comprehensibility, and patient and conversation partner ratings of conversation satisfaction significantly improved with the microphone on. Patients with lower baselines without the microphone in certain measures (intelligibility, comprehensibility) generally showed a greater microphone benefit than patients with higher baselines.

Conclusion: Use of a novel microphone integrated into NIV improved intelligibility during ventilation for both healthy volunteers and patients undergoing therapeutic NIV. Additional clinical studies will define precise benefits and implications of such improved intelligibility.

Keywords:

• non-invasive ventilation
• intelligibility
• speech amplification
• speech enhancement devices
• communication success
• patient communication

Disclosure statement

L.M.B. is a paid consultant for ReddyPort, Inc. L.M.B. also received a National Institues of Health Small Business Innovation Research (NIH SBIR) grant, which provided funding for the research in this work. Authors E.D.Y., S.H.F., B.F.S., and L.M.L. received funding support through the NIH SBIR grant to complete this work. Intermountain Healthcare and S.M.B. hold intellectual property in the underlying devices (ReddyPort^TM Elbow, ReddyPort^TM Microphone) and receive licencing fees for the use of both products.

Additional information

Funding

This work was supported under SBIR Phase 1 Grant 1R43HL147788-01A1 to Axon Medical Inc. for development of the ReddyPort^TM Microphone. The pilot study was registered as a clinical trial through the National Institutes of Health, identifier number NCT04912544. ReddyPort, Inc. supplied the ventilator masks, ReddyPort^TM Elbows, and ReddyPort^TM Microphones for all participants. We are grateful to A. M. Rasmussen for his help with stimulus processing and managing the listening experiments, as well as to all talkers and listeners for their participation.