Tracheostomy: from insertion to decannulation.

نویسندگان

  • Paul T Engels
  • Sean M Bagshaw
  • Michael Meier
  • Peter G Brindley
چکیده

Tracheostomy is a common surgical procedure, and is increasingly performed in the intensive care unit (ICU) as opposed to the operating room. Procedural knowledge is essential and is therefore outlined in this review. We also review several high-quality studies comparing percutaneous dilational tracheostomy and open surgical tracheostomy. The percutaneous method has a comparable, if not superior, safety profile and lower cost compared with the open surgical approach; therefore the percutaneous method is increasingly chosen. Studies comparing early versus late tracheostomy suggest morbidity benefits that include less nosocomial pneumonia, shorter mechanical ventilation and shorter stay in the ICU. However, we discuss the questions that remain regarding the optimal timing of tracheostomy. We outline the potential acute and chronic complications of tracheostomy and their management, and we review the different tracheostomy tubes, their indications and when to remove them.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Investigation of the Paediatric Tracheostomy Decannulation: Factors Affecting Outcome

Introduction: Evidence for factors determining paediatric tracheostomy decannulation vary extensively; therefore, this prospective observational study aimed to investigate these factors.   Materials and Methods: In total, 67 consecutive paediatric patients (<12 years old) who referred to the Department of Otolaryngology, (Postgraduate Institute Medical Education and Research),(Chandigarh), ...

متن کامل

Can an interprofessional tracheostomy team improve weaning to decannulation times? A quality improvement evaluation

BACKGROUND Percutaneous tracheostomy is a common procedure in the intensive care unit and, on patient transfer to the wards, there is a gap in ongoing tracheostomy management. There is some evidence that tracheostomy teams can shorten weaning to decannulation times. In response to lengthy weaning to decannulation times at Trillium Health Partners - Credit Valley Hospital site (Mississauga, Onta...

متن کامل

Tracheostomy Decannulation Kent L Christopher MD RRT Introduction Decannulation Decision Making Deflated-Cuff Tracheostomy Occlusion Procedure Benefits of Decannulation Protocol-Guided Decannulation Physiologic Effects of Decannulation

The respiratory therapist plays an integral role in tracheostomy tube decannulation. Removal of the tracheostomy tube should be considered only if the original upper-airway obstruction is resolved, if airway secretions are controlled, and if mechanical ventilation is no longer needed. Predictors of success include ability to produce a vigorous cough and the absence of aspiration. Tracheostomy d...

متن کامل

Utilization of a standardized tracheostomy capping and decannulation protocol to improve patient safety.

OBJECTIVES/HYPOTHESIS To develop and assess the feasibility of a new standardized protocol to guide tracheostomy decannulation. STUDY DESIGN Descriptive review of quality improvement project. METHODS A quality improvement project was conducted in the inpatient setting of a tertiary urban academic hospital. Adult patients who had received a tracheostomy and for whom the indication for trache...

متن کامل

Feasibility of a single-stage tracheostomy decannulation protocol with endoscopy in adult patients.

OBJECTIVES/HYPOTHESIS Gradual decrease in tube size and tube capping are considered the standard of care for tracheostomy decannulation. Both of these actions result in increased airway resistance. Immediate decannulation may offer a more tolerable approach. OBJECTIVE To assess the feasibility of immediate tracheostomy decannulation compared with the traditional decannulation methods. METHO...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Canadian journal of surgery. Journal canadien de chirurgie

دوره 52 5  شماره 

صفحات  -

تاریخ انتشار 2009