• Emily Otto, Ashley Kaspar, Keith Kerr, Gayle Droemer, and Allison Waddle.
• Emily Otto is a graduate student in speech, language, and hearing sciences, The University of Texas at Austin, Austin.
• Crit Care Nurse. 2024 Dec 1; 44 (6): 313431-34.

IntroductionNoninvasive ventilation therapy is a common approach in acute respiratory failure as an alternative to invasive mechanical ventilation. Assistive communication strategies are necessary to overcome communication impairments and anxiety caused by oronasal obstruction in pediatric intensive care unit patients undergoing noninvasive ventilation.Clinical Findings And DiagnosisA 7-year-old girl was admitted with a history of pulmonary arterial hypertension and recurrent respiratory failure requiring bilevel positive airway pressure intervention. The patient experienced initial lack of bilevel positive airway pressure mask compliance due to oronasal mask discomfort.InterventionsThe trial of a novel communication device (SPEAX, Ataia Medical) involving a microphone that attaches to the patient's bilevel positive airway pressure mask for enhanced communication.OutcomesUse of the assistive communication device was associated with increased intelligibility to familiar listeners, mask compliance, enhanced mobility, and reduced patient anxiety levels throughout hospitalization and in later episodes of readmission.ConclusionThe implementation of assistive communication devices can alleviate communication barriers in pediatric bilevel positive airway pressure users, contributing to increased compliance and diminished anxiety for patients and caregivers. Providing a pathway for effective communication may reduce sedation use, minimizing risks of sedation-related delirium and improving overall quality of life in these patients.©2024 American Association of Critical-Care Nurses.

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