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Tracheostomy care

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https://www.readbyqxmd.com/read/28301956/the-effect-of-tracheostomy-performed-within-72%C3%A2-h-after-traumatic-brain-injury
#1
Keita Shibahashi, Kazuhiro Sugiyama, Hidenori Houda, Yuichi Takasu, Yuichi Hamabe, Akio Morita
The optimal timing of tracheostomy in patients with traumatic brain injury (TBI) remains unclear. The purpose of this study was to examine the effects of tracheostomy performed within 72 h after admission. In this retrospective cohort study, the authors reviewed the data for a series of 120 consecutive patients who underwent tracheostomy after suffering TBI with an Abbreviated Injury Scale (AIS) score of ≥4. The exclusion criteria were as follows: age <18 years, severe chest injury with an AIS score of ≥4, and a requirement for intubation because of upper airway obstruction...
March 16, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28295658/successful-closure-of-post-tracheostomy-large-chronic-trachea-esophageal-fistula-with-new-over-the-scope-clip
#2
P Rai, R Bhargava
Acquired tracheo-esophageal fistula mostly occurs secondary to malignancy, infection, ruptured diverticula, and injuries.(1) Among the benign conditions, prolonged mechanical ventilation is the most common (47%), followed by injury (17%), prior laryngectomy (17%), and prior esophagostomy (17%).(2) A 19 y male had a road traffic accident and was managed in an intensive care unit with ventilator support and had tracheostomy for 20 days. This article is protected by copyright. All rights reserved.
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28288027/cumulative-probability-and-time-to-reintubation-in-u-s-icus
#3
Andrea N Miltiades, Hayley B Gershengorn, May Hua, Andrew A Kramer, Guohua Li, Hannah Wunsch
OBJECTIVE: Reintubation after liberation from mechanical ventilation is viewed as an adverse event in ICUs. We sought to describe the frequency of reintubations across U.S. ICUs and to propose a standard, appropriate time cutoff for reporting of reintubation events. DESIGN AND SETTING: We conducted a cohort study using data from the Project IMPACT database of 185 diverse ICUs in the United States. PATIENTS: We included patients who received mechanical ventilation and excluded patients who received a tracheostomy, had a do-not-resuscitate order placed, or died prior to first extubation...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28277332/dysphagia-management-in-tracheostomized-patients-where-are-we-now
#4
Diane Goff
PURPOSE OF REVIEW: Tracheostomized patients are medically complex and vulnerable. International attention is now focused on improving the safety and quality of their care. This review summarizes recent evidence in hot-topic areas pertinent to speech and language therapy (SLT) intervention for dysphagia management in tracheostomized patients. RECENT FINDINGS: The management of tracheostomized patients requires a truly multidisciplinary team (MDT) approach. Without this, patients remain tracheostomized and hospitalized for longer and have slower access to MDT members...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28273224/emergency-cricothyrotomy-temporary-measure-or-definitive-airway-a-systematic-review
#5
Marina Barguil Macêdo, Ruggeri Bezerra Guimarães, Sahâmia Martins Ribeiro, Kátia Maria Marabuco DE Sousa
Being a fast and safe method in the hands of well trained professionals in both prehospital and intrahospital care, Cricothyrotomy has been broadly recommended as the initial surgical airway in the scenario "can't intubate, can't ventilate", and is particularly useful when the obstruction level is above or at the glottis. Its prolonged permanence, however, is an endless source of controversy. In this review we evaluate the complications of cricothyrotomy and the need of its routine conversion to tracheotomy through a search on PubMed, LILACS and SciELO electronic databases with no restriction to the year or language of the publication...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28270863/respiratory-problems-and-management-in-people-with-spinal-cord-injury
#6
David J Berlowitz, Brooke Wadsworth, Jack Ross
Spinal cord injury (SCI) is characterised by profound respiratory compromise secondary to the level of loss of motor, sensory and autonomic control associated with the injury. This review aims to detail these anatomical and physiological changes after SCI, and outline their impact on respiratory function. Injury-related impairments in strength substantially alter pulmonary mechanics, which in turn affect respiratory management and care. Options for treatments must therefore be considered in light of these limitations...
December 2016: Breathe
https://www.readbyqxmd.com/read/28263440/a-decade-of-pediatric-tracheostomies-indications-outcomes-and-long-term-prognosis
#7
Mona L McPherson, Lara Shekerdemian, Michelle Goldsworthy, Charles G Minard, Cynthia S Nelson, Fernando Stein, Jeanine M Graf
OBJECTIVE: To define the mortality and long-term outcomes of children undergoing tracheostomy. DESIGN: Retrospective chart and Texas Department of Health Bureau of Vital Statistics review of patients admitted to a Pediatric Intensive Care Unit who underwent a tracheostomy between 2001 and 2011. Mortality and decannulation rates were compared based on tracheostomy indication and age. SUBJECTS: A total of 426 patients admitted to a Pediatric Intensive Care Unit in a large tertiary children's hospital...
March 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#8
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
March 1, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28250751/traumatic-brain-injury-and-palliative-care-a-retrospective-analysis-of-49-patients-receiving-palliative-care-during-2013-2016-in-turkey
#9
Kadriye Kahveci, Metin Dinçer, Cihan Doger, Ayse Karhan Yaricı
Traumatic brain injury (TBI), which is seen more in young adults, affects both patients and their families. The need for palliative care in TBI and the limits of the care requirement are not clear. The aim of this study was to investigate the length of stay in the palliative care center (PCC), Turkey, the status of patients at discharge, and the need for palliative care in patients with TBI. The medical records of 49 patients with TBI receiving palliative care in PCC during 2013-2016 were retrospectively collected, including age and gender of patients, the length of stay in PCC, the cause of TBI, diagnosis, Glasgow Coma Scale score, Glasgow Outcome Scale score, Karnofsky Performance Status score, mobilization status, nutrition route (oral, percutaneous endoscopic gastrostomy), pressure ulcers, and discharge status...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28241903/adult-epiglottitis-a-case-series
#10
Benjamin Lindquist, Sybil Zachariah, Anita Kulkarni
INTRODUCTION: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. CASE PRESENTATION: We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28239579/neck-trauma-ent-prospects
#11
Kavita Sachdeva, Aparaajita Upadhyay
Neck trauma is a very important surgical emergency faced by ENT surgeons in day to day practice. They are potentially life threatening conditions due to the presence of many vital structures in this area. Timely presentation to the referral centre and proper multidisciplinary approach towards management plays a pivotal role in the healing pattern of the wound and prevention of serious complication like shock, sepsis, laryngeal stenosis or fistula formation. A retrospective study was done in ENT Department, NSCB Medical College, Jabalpur, Madhya Pradesh, India during the period of 2014-2016...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28239576/cut-throat-injury-our-experience-in-rural-set-up
#12
Debdulal Chakraborty, Chiranjib Das, Arvind Kumar Verma, Rajesh Hansda
Cut throat injuries are one of the emergency conditions managed by ENT specialists. If not treated in time, they may lead to death. Prevention of these complications depends on immediate resuscitation by securing the airway by tracheostomy or intubation, prompt control of hemorrhage and blood replacement. The present study was conducted to study the sociodemographic profile of patients of cut throat injury, motives behind cut throat injury, site and depth of the injury, treatment given at our hospital and outcome...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28235525/iatrogenic-tracheal-laceration-in-the-setting-of-chronic-steroids
#13
Punit Singh, Margaret Wojnar, Anita Malhotra
We report the case of a 71-year-old woman with end-stage chronic obstructive pulmonary disease who presented with a 10-cm tracheal laceration from a presumed traumatic intubation in the setting of respiratory distress and chronic obstructive pulmonary disease exacerbation and subsequently developed significant subcutaneous emphysema along her neck and mediastinum in addition to her peritoneum and mesentery. We were successfully able to treat this patient conservatively up until the time that tracheostomy was warranted...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#14
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28229065/foreign-body-aspiration-in-adults-two-unusual-foreign-bodies-knife-and-tube-tracheostomy
#15
Seyed Mozafar Hashemi, Mohsen Kolahdouzan, Shahab Shahabi, Hamid Talebzadeh, Mohammad Taghi Rezaei
INTRODUCTION: Foreign body aspiration is usually a serious condition that is most common among the pediatric population, and rare in adults. In adults, aspiration may be tolerated for a long time. CASE REPORTS: Our first case is a 38-year-old man who presented with a 2-day history of swallowing a foreign body. He was completely asymptomatic. Chest X-ray revealed the presence of 5-cm foreign object in the right main bronchus. Rigid bronchoscopy was performed and a knife was removed from the right main bronchus...
January 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#16
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199137/patient-and-hospital-characteristics-associated-with-inter-hospital-transfer-for-adults-with-ventilator-dependent-respiratory-failure
#17
Nandita R Nadig, Andrew J Goodwin, Annie N Simpson, Kit N Simpson, Jeremy Richards, Dee W Ford
RATIONALE: Patients with ventilator-dependent respiratory failure have improved outcomes at centers with greater expertise, yet most patients are not treated in such facilities. Efforts to align care for respiratory failure and hospital capability would necessarily require inter-hospital transfer. OBJECTIVES: To characterize the prevalence and patient and hospital factors associated with inter-hospital transfer of adults residing in Florida with ventilator-dependent respiratory failure...
February 15, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28197044/the-impact-of-early-tracheostomy-in-neurotrauma-patients-a-retrospective-study
#18
Kapil G Zirpe, Deepali Vishnu Tambe, Abhijit M Deshmukh, Sushma K Gurav
BACKGROUND: Although majority of neurotrauma patients require long term ventilatory support but the timing of tracheostomy in such patients is controversial. METHOD: This retrospective study was conducted at a Tertiary Care Hospital, Pune, India. Patients >18 years of age, who underwent percutaneous tracheostomy (PCT) from June 2010 to November 2014 at neurotrauma unit (NTU) of hospital, were included. Patients were divided in two groups according to the timing of tracheostomy, early tracheostomy (ET) group (≤5 days; N=100) and late tracheostomy (LT) group (>5 days; N=64)...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#19
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28190872/upper-airway-obstruction-requiring-emergent-tracheostomy-secondary-to-laryngeal-sarcoidosis-a-case-report
#20
Changwan Ryu, Erica L Herzog, Hongyi Pan, Robert Homer, Mridu Gulati
BACKGROUND Laryngeal sarcoidosis is a rare extrapulmonary manifestation of sarcoidosis, accounting for 0.33-2.1% of cases. A life-threatening complication of laryngeal sarcoidosis is upper airway obstruction. In this report we describe our experience in the acute and chronic care of a patient who required an emergent tracheostomy, with the aim to provide further insight into this difficult to manage disease. CASE REPORT A 37-year-old African American female with a 10-year history of stage 1 sarcoidosis presented with severe dyspnea...
February 13, 2017: American Journal of Case Reports
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