Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tracheotomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2000

Endoscopically monitored percutaneous dilational tracheotomy in a residency program.

OBJECTIVES/HYPOTHESIS: Endoscopically guided percutaneous dilational tracheotomy (PDT) has become a well-established alternative to the more traditional open tracheotomy, yet its use by otolaryngologists is limited. As airway management specialists, otolaryngologists should be familiar with a wide range of definitive procedures, including PDT. Few otolaryngology programs teach the technique. The objective of the present study was to determine the complication rate and outcome of PDT after its introduction in a residency teaching program. We also wished to evaluate whether the time savings reported by experienced surgeons could be repeated in our setting. SETTING: Tertiary referral teaching hospital. METHODS: We prospectively reviewed our first 54 consecutive PDTs and compared them to 29 consecutive standard open tracheotomies, which were reviewed retrospectively. RESULTS: Complications (13% vs. 33%, P = .030), operative time (12 vs. 24 min, P < .0001) and total procedure time (37 vs. 80 min, P < .001) were significantly reduced in the PDT group as compared with standard tracheotomy. Initial outcome data were equal in both groups. CONCLUSIONS: We found that PDT can be safely and effectively taught as part of an otolaryngology residency training program.

Aged↗
PubMed1983

Acute epiglottitis in children: experiences with tracheotomy and intubation.

Acute epiglottitis is one of the most serious and potentially fatal conditions dealt with in paediatric laryngology. The infectious agent is mostly Haemophilus influenzae. An active and planned treatment to secure the airway is necessary to reduce the morbidity and mortality. The 'watch and wait' attitude should be abandoned. Tracheotomy or intubation should be performed. Mostly literature today is in favour of intubation. However, both tracheotomy and intubation can be used, and if properly managed the complication rate with both methods is low. This series comprised 102 children of whom 79 were tracheotomized and 23 were intubated. No differences could be found between intubation or tracheotomy time (2.3 and 2.9 days respectively) or in hospital stay (6.7 and 6 days). The complication rate was low in both groups except for subcutaneous and mediastinal emphysema in the tracheotomy group but these did not cause any serious problems.

Adolescent↗
PubMed1990

Quantitative study of the early effects of tracheotomy and endotracheal intubation on the rabbit tracheobronchial tree.

Histopathologic evaluation of the tracheobronchial tree was performed in 12 rabbits to study the effects of 1 hour of tracheotomy or endotracheal intubation. In five animals who underwent oral endotracheal intubation, epithelial erosions and submucosal inflammation in the proximal (bronchial) airway covered 34.9% and 71.3% of the luminal circumference, respectively. This was highly significant (p less than .001) against two control animals, in which 4.8% erosion and 3.9% inflammation were observed. Tracheotomy in three animals caused 22.8% bronchial epithelial erosion and 46.0% inflammation, which were not significantly greater than values of 15.0% and 20.6% observed following "sham" tracheotomy. The severity of the proximal (indirect) consequences of endotracheal intubation may have been attributable to the lack of humidification, but this does not explain the lesser damage caused by tracheotomy. It is postulated that increased inspiratory flow rate and pressures occurring in endotracheally intubated animals may be contributory factors.

Animals↗
PubMed1994

Tracheotomy and the role of postoperative chest radiography in adult patients.

A retrospective review of 100 adult tracheotomies performed by the University of Washington Department of Otolaryngology-Head and Neck Surgery was done to evaluate our complication rate and the role of postoperative chest radiography (CXR). In an attempt to identify specific risk factors for pneumothorax (PTX), the following items were reviewed: age, urgency (elective, urgent, and emergent), awake or general anesthesia, diagnosis (reason for tracheotomy), "difficulty" of tracheotomy, postoperative signs or symptoms of PTX, and findings on postoperative CXR. The series had a PTX rate of 2%. Both patients with complications reviewed here had definite risk factors, or signs and symptoms of PTX. The causes, risk factors, and treatments for PTX are reviewed. Postoperative CXR is indicated in cases at increased risk for PTX, and in patients with clinical signs or symptoms of PTX. Had we followed our proposed criteria, we would have performed postoperative CXR 13 times instead of 93. This would have resulted in a total savings of $10,020. We conclude that postoperative CXR after a routine, uncomplicated tracheotomy is of low yield and incurs unnecessary expense.

Adult↗
PubMed2001

The role of tracheotomy in weaning.

Tracheotomy is commonly performed in ventilator-dependent patients. Disadvantages to the procedure are perioperative complications, long-term airway injury, and the cost of the procedure. Benefits ascribed to tracheotomy vs prolonged translaryngeal intubation include improved patient comfort, more effective airway suctioning, decreased airway resistance, enhanced patient mobility, increased potential for speech, ability to eat orally, a more secure airway, accelerated ventilator weaning, reduced ventilator-associated pneumonia, and the ability to transfer ventilator-dependent patients from the ICU. None of these benefits, however, have been demonstrated in large-scale, prospective, randomized studies. It is proposed that there should be an anticipatory approach wherein tracheotomy is considered after an initial period of stabilization with the patient receiving mechanical ventilation when it becomes apparent that the patient will require prolonged ventilator assistance. Tracheotomy then is performed when the patient appears likely to gain one or more of the benefits ascribed to the procedure.

Airway Resistance↗
PubMed1995

The technique of tracheotomy and cricothyroidotomy. When to operate--and how to manage complications.

Tracheotomy can relieve upper airway obstruction, improve pulmonary hygiene, and support long-term mechanical ventilation. Consider performing a tracheotomy whenever the need for more than 14 days of ventilatory support is anticipated. When emergent airway access is needed and translaryngeal intubation is not possible, consider cricothyroidotomy. For a tracheotomy, make a transverse incision 1 cm above the suprasternal notch or, for cricothyroidotomy, through the superficial cricothyroid membrane. Accidental tube displacement within 5 days of surgery is potentially tracheotomy's most lethal early complication. Many late complications can be prevented by careful management and expert nursing support.

Airway Obstruction↗
PubMed2001

Late sequelae of percutaneous tracheotomy compared to epithelized tracheostomy.

BACKGROUND: Since Ciaglia described in 1985 the method of percutaneous dilational tracheotomy at first time, it has emerged to be a favored used technique in the treatment of critically ill patients to prevent the complications associated with prolonged translaryngeal intubation. There are currently several commercial kits for sequential dilatational percutaneous tracheotomy available. Essential advantages are the simplicity, rapidity, low risk and independence of the physician. But there are also risks for long time complications with essential disadvantages for neurologic and phoniatric rehabilitation. PATIENTS: From September 1997 to September 1999 we examined 168 patients with tracheostoma of three different rehabilitation centers with special attention to early rehabilitation. The examinations included an endoscopic control of the subglottic area, the stoma and the trachea until the bifurcation. RESULTS: During our examinations we mainly found pathological findings in the subglottic area and the stoma himself with an important difference between the percutaneous tracheotomy and the epithelized tracheostomy. CONCLUSIONS: There is a need for critical indications in performing the percutaneous tracheotomy. We propose its use for short-time only. Critically ill patients with a tracheostoma in requirement of a airway bypass more than 6 weeks should get an epithelized tracheostomy primarily.

Adolescent↗
PubMed2002

[Difficult airway management in a patient with history of tracheotomy].

A 12-year-old girl was scheduled to undergo tympanoplasty. She had received tracheotomy at the age of 10 months. As preoperative bronchofiberscope could reach the glottis with no difficulty, we chose rapid induction. Suddenly after the administration of thiopental, fentanyl and vecuronium bromide, we could not keep mask ventilation. As sniffing position and insertion of airway could not improve difficult ventilation, we intubated quickly. The intubation was easy. We consider that difficult ventilation was not due to upper airway trouble but due to tracheotomy. Muscles around the granuloma were relaxed, and the trachea was closed, just at the height of tracheotomy. We conclude that it may sometimes be difficult in a child with history of tracheotomy to keep mask ventilation.

Adolescent↗
PubMedDate not supplied

[Study of clean versus aseptic technique of tracheotomy care based on the level of pulmonary infection].

The purpose of this research study was to determine whether the clean technique of tracheotomy care is the same, or more, secure from the aseptic, by testing the difference in the level of postoperative pulmonary infection between tracheotomized patients receiving aseptic and those receiving clean tracheotomy care. The sample consisted of 103 patients with tracheotomy (transient or permanent) from ENT or IC units of four big hospitals of Athens. The level of the patient's pulmonary infection was defined using the Weighted Level of Pulmonary Infection Tool, which was constructed especially for this research study. The data were analysed using the x2 statistical test, and the coefficients phi, Cramer's V and Kendall's, while, with the same statistics, the relationship between certain important external variables and the dependent variable was examined. The findings indicated that no statistically significant difference exists between clean and aseptic technique as to the level of pulmonary infection when used for tracheotomy postoperative care of tracheotomized patients.

Adult↗
PubMed2003

[The time and indication for tracheotomy when inhalation injury].

OBJECTIVE: To discuss the time and indication of tracheotomy for patients with inhalation injury. METHOD AND RESULT: One hundred and twenty four cases were under tracheotomy in 1-24 hours after burn in which 85 were gentle (11 died after operation), 22 moderate (9 died post-operation), 17 severe (11 died post-operation), 24 hours later there were 51 cases were operated in which the gentle 12 (8 died after operation), the moderate 34 (15 died post-operation) and the severe 5 (5 died post-operation). There were 5 patients had died before tracheotomy. There were 21 cases with cervical annular and deminannular eschar, 90 cases with severe burn in head and face, and 32 cases with fish mouths, 37 cases with blood serum bleeding in mouth and nose cavities. CONCLUSION: The crisis of larynx obstruction is the most important factor of causing death, and the earlier tracheotomy in patients with inhalation injury can reduce the incidence of larynx obstruction crisis and mortality.

Adolescent↗
PubMedDate not supplied

[Bronchoscopic removal of foreign body from airway through tracheotomy or tracheostomy].

OBJECTIVE: Most foreign bodies in the airway are removed by respiratory endoscopy. Rarely, the removal of the foreign body has to be performed through endoscopic control by tracheotomy or tracheostomy. This article reports three cases of foreign body removal in children performed by tracheal opening. DESCRIPTION: Retrospective review of records with report of three cases of children who aspirated foreign bodies into the airway. In the first case, there was rupture of the tracheostomy tube, with aspiration of its distal portion. Endoscopic removal was performed by tracheostomy. The second child aspirated a pen cap. It could not be removed by endoscopy because it would not pass through the subglottic region. Cervical tracheotomy was performed and the foreign body was removed with endoscopic control. In the last case, the foreign body was in the left main bronchus. It was removed by bronchoscopy through tracheostomy opening. All children presented good outcome after the endoscopic procedure. The trachea of the patient submitted to tracheotomy was sutured after the foreign body removal. Tracheostomy was not necessary. In the children with previous tracheostomy, the tube was put back after the foreign body removal. COMMENTS: Most foreign bodies in the airway of children can be removed by endoscopy. When the foreign body is too large to pass through the subglottic region, or so sharp that it can injure the airway, the use of tracheotomy or tracheostomy is indicated.

Airway Obstruction↗
PubMed1992

Practical aspects of pediatric tracheotomy care.

Infants and children who manifest respiratory distress secondary to congenital or acquired abnormalities of the airway pose a unique problem that frequently requires a tracheotomy to control the patient's airway. These tracheotomies often are required for extended periods of time. Skilled care and astute observation are essential for the care of these patients while in hospital and at home. Although many of the care concerns relate to nursing and social issues, the otolaryngologist must maintain an active role in the medical management and co-ordination of discharge. This paper provides the otolaryngologist with an outline of the hospital care required for the pediatric tracheotomy patient. Additionally, it offers the otolaryngologist a model program for discharge planning and follow-up for the pediatric tracheotomy patient in the community.

Child↗
PubMed2006

[Central venous catheter as a reason of bleeding after tracheotomy].

Tracheotomy as an operation may be connected with many complications. One of them is intra- or postoperative bleeding. A lot of reasons of such bleeding is well known, but we describe a case of bleeding caused by central venous catheter which was inserted into external jugular vein, but dislocated into anterior jugular vein and destructed it's wall. The bleeding observed after tracheotomy was firstly counted as an effect of coagulation defect connected with heparin supply. When few days after tracheotomy the tip of the catheter was seen in the tracheotomy, patient was quickly operated--the destructed anterior jugular vein and external jugular vein were ligated and the central venous catheter was removed.

Catheterization, Central Venous↗
PubMed1990

[Long-term intubation and tracheotomy].

Benefits and disadvantages of long-term nasal and oral endotracheal intubations vs. tracheotomy are discussed. The incidence and severity of complications is higher following prolonged endotracheal intubation than tracheotomy. Laryngeal injury is more serious than tracheal. Tracheotomy therefore is advantageous in all patients requiring long-term ventilatory support. The optimal timing for tracheotomy is ranging from 48 to 120 hours following endotracheal intubation. Tracheal stenosis secondary to trachestomy depends on tracheal wall perfusion. The risk of tracheal stenosis may be minimized by diligent performance of tracheostomy, and by sewing the trachea to the skin, and by using solidly fixed tracheal cannulas with high-volume low-pressure cuffs.

Airway Resistance↗
PubMed1984

Pediatric tracheotomy.

The indications and complications of tracheotomy in 93 children between 1970-82 were studied and recorded. There has clearly been a shift in indications for pediatric tracheotomy while the early postoperative complication rate has improved. Longterm tracheotomy is on the increase due to a larger number of children with neurological problems and of infants requiring tracheotomy for chronic obstructive airway disease.

Adolescent↗
PubMedDate not supplied

Clean vs. sterile tracheotomy care and level of pulmonary infection.

As reported in the literature and observed in clinical practice, a variety of tracheotomy care procedures (tracheotomy suctioning and cleaning techniques) are currently used. The purpose of this research was to determine if clean tracheotomy care was more effective than sterile as measured by levels of postoperative pulmonary infection. Ten hospitals with large Head and Neck/ENT services were selected as data collection sites. At these centers a minimum of 15 tracheostomy patient charts were reviewed pre- and postoperatively for clinical and laboratory data related to infection. Patient level of infection was defined using the Weighted Level of Pulmonary Infection Tool, which was constructed for this study. Three categories of aseptic type emerged (clean, sterile, and mixed) because existing tracheotomy care procedures did not fall into one of the two hypothesized types. Data were analyzed using a maximum likelihood approach to mixed model analysis of variance or covariance. The findings indicated significant differences among the three procedures with laboratory, but not clinical, data. Laboratory data supported practicing clean procedures as those associated with the least postoperative infection.

Analysis of Variance↗
PubMed1993

Tracheotomy in the first year of life.

Tracheotomy in infants is considered to be associated with a high complication rate. This study was conducted to establish the indications and complications associated with tracheotomy in patients less than one year old. The charts of 44 consecutive infants operated on between 1982 and 1991 at the Montreal Children's Hospital were reviewed. The intra-operative complication rate was 9%; the postoperative was 18%. Home care was associated with a very low morbidity. The mortality attributable to tracheotomy was 5%. Significant complications were associated with the lack of availability of the correct size tracheotomy cannula. This study finds a significant rate of complications in the infant age group, but differs from other studies in finding that very premature neonates do not experience a higher rate of complications.

Female↗
PubMed1996

Prognostic value of Glasgow Coma Scale for tracheotomy in head injured patients.

The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify the head injured patients who will eventually undergo tracheotomy. Authors' present retrospective study reveals that the likelihood of tracheotomy is significantly greater in patients with a GCS rating < 7 than in those with a GCS rating > 7 (p < 0.01). In order to minimize complications and make tracheotomy patients feeling more comfortable and communicable, this study argues for early tracheotomy in patients with a GCS score < 7, but never before 72 hours after injury, because it is a time necessary for patient stabilization and elimination of any illicit drugs or alcohol used prior to head injury.

Adolescent↗