Understanding vocal cord dysfunction: a step in the right direction with a long road ahead.
Explore the source record for details and available documents.
Asthma↗
Biomedical subjects
Kent L Christopher
Publications and source records attributed to Kent L Christopher.
Tracheostomy 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 decannulation requires caution, particularly following a prolonged period of tracheostomy use. The tracheostomy tube decannulation process is well suited for therapist-implemented protocols.
Clinical Protocols↗
Transtracheal oxygen catheters.
Over the past 20 years a variety of transtracheal catheters have been developed for long-term oxygen therapy. A modified Seldinger technique has been the standard in the past, but a more recent procedure for surgical creation of the tracheocutaneous tract presents a number of potential advantages. TTO should be administered as a program of care, and recent advances with a streamlined and shortened program have simplified and improved the delivery of a technology that has a number of potential benefits and established safety. TTO may further increase the oxygen conservation efficiency of demand oxygen controller devices, and studies have shown TTO to be a potential alternative to nasal oxygen, continuous positive airway pressure, and tracheotomy for severe obstructive sleep apnea. Very high flows (> 10 L/minute) of a humidified air/oxygen blend, termed transtracheal augmented ventilation, extend the physiologic benefits of TTO and have promise in both the outpatient nocturnal ventilatory support of patients with severe respiratory disease and in liberation of patients from prolonged mechanical ventilation.
Animals↗