INTRODUCTION Tracheotomy is one of the most frequent surgical procedures performed in critically ill patients hospitalized at intensive care units. The ideal timing for a tracheotomy is still controversial, despite decades of experience. OBJECTIVE To determine the impact of performing early tracheotomies in critically ill patients on duration of mechanical ventilation, intensive care unit sta...

The procedure of tracheotomy dates back to ancient times. Its use has been adapted in the neonatal and pediatric population over the past half-century. Despite being a life-saving measure, tracheotomy-related mortality rates range from 0.5 to 3.6%, and this procedure is not without significant and sometimes frequent complications. Techniques regarding pediatric tracheotomy vary from surgeon to ...

UNLABELLED We report a case of a 59-year-old male who experienced tracheoesophageal fistula and grade IV subglottic stenosis after percutaneous dilation tracheotomy. Although percutaneous tracheotomy is considered a safe procedure that is often performed in the intensive care unit setting, it is not without complications. While subglottic stenosis and tracheoesophageal fistula are known complic...

TETANUS BEnIJO been found by Adriani and Kerr (1955) to be the most effective drug. First used in neonates, we have used it with success in the last seven older children. In three children treated with paraldehyde, phenobarbitone, and tracheotomy who were having such severe spasms that I.P.P.R. was contemplated, a change from paraldehyde to mephenesin resulted in satisfactory control. In adults...

OBJECTIVE To define the indications for tracheotomy in patients requiring prolonged intubation (>1 week) in the pediatric intensive care unit (PICU). DESIGN Retrospective chart review and follow-up telephone survey. SETTING A tertiary care center PICU. OUTCOME MEASURE Tracheotomy or extubation. PATIENTS All patients older than 30 days in the PICU intubated for longer than 1 week between...

INTRODUCTION Translaryngeal intubated and ventilated patients often need sedation to treat anxiety, agitation and/or pain. Current opinion is that tracheotomy reduces sedation requirements. We determined sedation needs before and after tracheotomy of intubated and mechanically ventilated patients. METHODS We performed a retrospective analysis of the use of morphine, midazolam and propofol in ...

OBJECTIVE To identify clinical factors associated with enteral feeding tube placement in a head and neck cancer population. DESIGN A self-administered survey was given to patients being treated for head and neck cancer while they were waiting to be seen in 1 of 4 otolaryngology clinics. The post hoc analysis presented here combines survey and chart review data to determine clinical and demogr...

OBJECTIVE To compare conventional tracheotomy with endotracheal intubation to tracheotomy with noninvasive positive-pressure ventilation (NPPV) in advanced neuromuscular disease. METHODS This was a retrospective study of a historical cohort of patients tracheotomized while sedated and intubated versus patients tracheotomized under NPPV and local anesthesia. We recorded previous intubation dif...

OBJECTIVE Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level. METHODS A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational trache...