BACKGROUND Tracheostomy is a common surgical procedure performed on critically ill patients. However, little is known about how clinicians make decisions to decannulate patients, and whether similar decisions are made by respiratory therapists (RTs) and physicians. METHODS We performed a cross-sectional survey of RTs (n = 52) and physicians (n = 102) at 54 medical centers in North America, to...

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...

We report the cases of three patients with Björk-Shiley convexo-concave heart valves with unusual black holes shown on cerebral MR images. For two patients, these findings were associated with fracture of the Björk-Shiley convexo-concave heart valve, and for the third, with worn surfaces on the heart valve. Susceptibility changes shown by MR imaging suggest the possibility that these black hole...

IMPORTANCE Tracheotomy is a common procedure. Postoperative care is usually managed by nonexpert clinicians. Prolonged decannulation is associated with a high incidence of complications. At present, no clinical protocol exists to guide clinicians through decannulation. To address this deficiency, we developed a low-risk tracheotomy clinical pathway. OBJECTIVE To determine the effect of our lo...

OBJECTIVE To investigate improved dysphagia after the decannulation of a tracheostomy in patients with brain injuries. METHODS The subjects of this study are patients with brain injuries who were admitted to the Department of Rehabilitation Medicine in Myongji Hospital and who underwent a decannulation between 2012 and 2014. A video fluoroscopic swallowing study (VFSS) was performed in order ...

The aim of this study was to demonstrate the differences between adult and pediatric tracheotomies in terms of indications, early and late complications and decannulation time. A total of 136 (53 children, 83 adult) patients who underwent tracheotomy between 2006 and 2011 were studied. Prolonged intubation was the most common indication in children (84.9%), whereas in the adult group, upper air...

Tracheostomy decannulation has always been considered a procedure with an attendant risk, especially in patients with a reduced upper airway diameter as is commonly observed in the obstructive sleep apnoea (OSA) population. We report on 4 cases where transoral robotic surgery (TORS) helped in the management of long-term cannulated patients. The aims of our paper are: 1. To demonstrate how the o...

The purpose of this study was to prospectively compare parameters that might predict successful translaryngeal extubation and tracheostomy tube decannulation. Irrespective of ventilatory function, 62 extubation/decannulation attempts were made on 49 consecutive patients with primarily neuromuscular ventilatory insufficiency who satisfied criteria. Thirty-four patients required 24-h ventilatory ...

Tracheostomy is a common surgical procedure performed in patients with severe head injury to facilitate prolonged airway and ventilatory support. Decannulation is the procedure of removing the tracheostomy tube either gradually by downsizing the tube or abruptly in a single sitting. This prospective study was done to evaluate gradual vs abrupt techniques for successful decannulation in tracheos...

To provide recommendations to otolaryngologists, pulmonologists, and allied clinicians for tracheostomy decannulation in pediatric patients. An iterative questionnaire was used establish expert by the members of International Pediatric Otolaryngology Group. Twenty-six completed survey. Recommendations address patient criteria readiness, airway evaluation prior decannulation, protocol, follow-up...