Although the existing evidence is limited, voiceless patients regard augmentative and alternative communication (high-tech AAC) devices as a useful, reliable, and acceptable alternative communication choice in the ICU. Multicenter, large-sample, and high-quality studies are highly recommended in the future.

18 studies with a total of 914 patients met the inclusion criteria, and the quality of the studies varied from low to moderate.

Based on the TAM, ICU voiceless patients perceived that high-tech AAC was useful, was easy to use, decreased communication difficulties, reduced negative emotions, and improved symptom identification and management.

Patients maintained a positive attitude and were willing to continue to use high-tech AAC.

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