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https://www.readbyqxmd.com/read/28649385/the-practice-of-tracheostomy-decannulation-a-systematic-review
#1
REVIEW
Ratender Kumar Singh, Sai Saran, Arvind K Baronia
Decannulation is an essential step towards liberating tracheostomized patients from mechanical ventilation. However, despite its perceived importance, there is no universally accepted protocol for this vital transition. Presence of an intact sensorium coordinated swallowing and protective coughing are often the minimum requirements for a successful decannulation. Objective criteria for each of these may help better the clinical judgement of decannulation. In this systematic review on decannulation, we focus attention to this important aspect of tracheostomy care...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28648671/late-complications-of-percutaneous-tracheostomy-using-the-balloon-dilation-technique
#2
J B Araujo, J M Añón, A García de Lorenzo, A M García-Fernandez, M Esparcia, J Adán, S Relanzon, D Quiles, V de Paz, A Molina
OBJECTIVE: The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. DESIGN: A prospective, observational cohort study was carried out. SCOPE: Two medical-surgical intensive care units (ICU). PATIENTS: All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy...
June 22, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28647928/pre-procedural-ultrasonography-for-tracheostomy-in-critically-ill-patients-a-prospective-study
#3
Ella Even-Tov, Itzhak Koifman, Vladimir Rozentsvaig, Leonid Livshits, Peter Gilbey
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) has become a standard technique for critically ill patients who require long-term ventilation. The most common early post-operative complication is bleeding related to anatomical variation in vasculature. The procedure is performed at the patient's bedside unless this is deemed unsafe and then the accepted alternative is open tracheostomy in the operating room. OBJECTIVES: To evaluate the use of pre-procedural ultrasound to aid in the decision of whether PDT in critical care patients should be performed at the patient's bedside or by open surgical tracheostomy...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28637077/-tracheostomy-home-care-of-patients-after-long-term-ventilation-on-the-icu-a-position-paper
#4
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#5
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28622012/tracheobronchomalacia-is-associated-with-increased-morbidity-in-bronchopulmonary-dysplasia
#6
Erik B Hysinger, Nicholas L Friedman, Michael A Padula, Russell T Shinohara, Huayan Zhang, Howard B Panitch, Steven M Kawut
RATIONALE: Tracheobronchomalacia is a common comorbidity in neonates with bronchopulmonary dysplasia. However, the effect of tracheobronchomalacia on the clinical course of bronchopulmonary dysplasia is not well-understood. OBJECTIVE: We sought to assess the impact of tracheobronchomalacia on outcomes in neonates with bronchopulmonary dysplasia in a large, multi-center cohort. METHODS: We preformed a cohort study of 974 neonates with bronchopulmonary dysplasia admitted to 27 neonatal intensive care units participating in the Children's Hospital Neonatal Database who had undergone bronchoscopy...
June 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#7
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#8
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28610562/end-stage-renal-disease-a-risk-factor-of-deep-neck-infection-a-nationwide-follow-up-study-in-taiwan
#9
Geng-He Chang, Ming-Shao Tsai, Chia-Yen Liu, Meng-Hung Lin, Yao-Te Tsai, Cheng-Ming Hsu, Yao-Hsu Yang
BACKGROUND: Uremia is likely a risk factor for deep neck infection (DNI). However, only a few relevant cases have been reported, and evidence sufficient to support this hypothesis is lacking. The aim of the study is to investigate the effects of end-stage renal disease (ESRD) on DNI. METHODS: We used the database of the Registry for Catastrophic Illness Patients (RFCIP), a subset of the National Health Insurance Research Database (NHIRD) in Taiwan, to conduct a retrospective follow-up study...
June 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28607676/evaluating-the-quality-improvement-impact-of-the-global-tracheostomy-collaborative-in-four-diverse-nhs-hospitals
#10
Brendan A McGrath, James Lynch, Barbarella Bonvento, Sarah Wallace, Val Poole, Ann Farrell, Cristina Diaz, Sadie Khwaja, David W Roberson
Tracheostomies are predominantly used in Head & Neck Surgery and the critically ill. The needs of these complex patients frequently cross traditional speciality working boundaries and locations and any resulting airway problems can rapidly lead to significant harm. The Global Tracheostomy Collaborative (GTC) was formed in 2012 with the aim of bringing together international expertise in tracheostomy care in order to bring about rapid adoption of best practices and to improve the quality and safety of care to this vulnerable group...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28594588/impact-of-bedside-tracheostomy-on-procalcitonin-kinetics-in-critically-ill-patients
#11
Koji Sato, Masaki Okajima, Toru Noda, Takumi Taniguchi
BACKGROUND: Critically ill patients are particularly vulnerable to invasive procedures and complications; however, tracheostomy is frequently performed in the intensive care unit (ICU). We analyzed the effects of tracheostomy on procalcitonin (PCT) kinetics and investigated whether PCT could reliably predict septic complications after tracheostomy. METHODS: We retrospectively identified 134 patients who underwent bedside tracheostomy during their ICU stay at a Japanese university hospital from October 2010 to December 2015...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28590065/safety-and-efficacy-of-laryngeal-mask-airway-ventilation-in-obese-patients-with-airway-stenosis
#12
D Cole Pourciau, D Peter Hotard, Schuylor Hayley, Kasey Hayley, Collin Sutton, Andrew J McWhorter, Daniel S Fink
OBJECTIVE: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis. STUDY DESIGN: A retrospective chart review was conducted in an academic practice in a tertiary care center. METHODS: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O2 saturation and maximum-end tidal carbon dioxide (CO2 ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded...
June 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28585496/preoperative-tracheostomy-is-associated-with-poor-disease-free-survival-in-recurrent-laryngeal-cancer
#13
Andrew C Birkeland, Andrew J Rosko, Lauren Beesley, Emily Bellile, Steven B Chinn, Andrew G Shuman, Mark E Prince, Gregory T Wolf, Carol R Bradford, J Chad Brenner, Matthew E Spector
Objectives It is unknown if preoperative tracheostomy for persistent/recurrent laryngeal squamous cell carcinoma (LSCC) plays a role in unrecognized local disease spread and disease recurrence after salvage laryngectomy. The goals of this study were to determine the effect of preoperative tracheostomy on disease-free survival (DFS) in patients with recurrent/persistent LSCC undergoing salvage laryngectomy. Study Design Retrospective case series derived from prospectively maintained database. Setting Tertiary care academic center...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28578113/safety-of-percutaneous-dilatational-tracheostomy-in-patients-with-acute-brain-injury-and-a-reduced-pao2-fio2-ratio-a-retrospective-analysis-of-54-patients
#14
Claudia Ditz, Jann F Wojak, Emma Smith, Abdulkareem Abusamha, Volker M Tronnier, Jan Gliemroth, Jan N Kuechler
OBJECTIVE: Percutaneous Dilatational Tracheostomy (PDT) is a commonly performed method in neurocritical care, whose safety has been proven in numerous studies. Nevertheless, there are poor data regarding the application in patients with acute brain injury and poor respiratory function. The purpose of this study was to evaluate the incidence of hypoxemia and hypercapnia during PDT in those patients. METHODS: In a retrospective analysis, we acquired data from 54 patients with an acute brain injury (ABI) and a reduced PaO2/FiO2 ratio (PaO2/FiO2<300mmHg)...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28574532/association-between-opioid-and-benzodiazepine-use-and-clinical-deterioration-in-ward-patients
#15
Patrick G Lyons, Ashley Snyder, Sarah Sokol, Dana P Edelson, Babak Mokhlesi, Matthew M Churpek
BACKGROUND: Opioids and benzodiazepines are frequently used in hospitals, but little is known about outcomes among ward patients receiving these medications. OBJECTIVE: To determine the association between opioid and benzodiazepine administration and clinical deterioration. DESIGN: Observational cohort study. SETTING: 500-bed academic urban tertiary-care hospital. PATIENTS: All adults hospitalized on the wards from November 2008 to January 2016 were included...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28556570/what-families-have-in-the-emergency-tracheostomy-kits-identifying-gaps-to-improve-patient-safety
#16
Reshma Amin, Weeda Zabih, Faiza Syed, Joanna Polyviou, Tuyen Tran, Evan J Propst, Theresa Holler
OBJECTIVE: To evaluate the contents of parent-created emergency tracheostomy kits and identify deficiencies. METHODS: This was an observational study. Data on emergency tracheostomy kits were abstracted for 30 consecutive children who had a tracheostomy tube in situ during an outpatient clinic visit with the Division of Respiratory Medicine and/or the Department of Otolaryngology-Head and Neck Surgery at the Hospital for Sick Children between February 1 and October 30, 2016...
May 29, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#17
Karen F Watters
Over the last decade, tracheostomy has been increasingly performed in children, aligned with the improvements in neonatal and pediatric ICU care. Nowadays, the majority of children with tracheostomy represent a very complex cohort of patients with sustained reliance on tracheostomy and related medical technology for long-term survival. Tracheostomy is one of the most commonly performed procedures in the adult ICU. Contrary to adult practice, tracheostomy is a much less common procedure in the pediatric ICU, being performed in < 3% of patients...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28543108/complications-and-30-day-hospital-readmission-rates-of-patients-undergoing-tracheostomy-a-prospective-analysis
#18
Emily Spataro, Nedim Durakovic, Dorina Kallogjeri, Brian Nussenbaum
OBJECTIVE: To determine inpatient and outpatient tracheostomy complication rates and 30-day hospital readmission rates, and to assess patient and procedural risk factors associated with complications and readmissions. STUDY DESIGN: Prospective cohort study. METHODS: Adult patients undergoing tracheostomy at a single academic hospital performed by any service, for any indication, were enrolled in this study over the course of 1 year. All patients had complete 30-day follow-up after discharge to determine complication and hospital readmission rates...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28534851/respiratory-care-considerations-for-children-with-medical-complexity
#19
REVIEW
Jackie Chiang, Reshma Amin
Children with medical complexity (CMC) are a growing population of diagnostically heterogeneous children characterized by chronic conditions affecting multiple organ systems, the use of medical technology at home as well as intensive healthcare service utilization. Many of these children will experience either a respiratory-related complication and/or they will become established on respiratory technology at home during their care trajectory. Therefore, healthcare providers need to be familiar with the respiratory related complications commonly experienced by CMC as well as the indications, technical and safety considerations and potential complications that may arise when caring for CMC using respiratory technology at home...
May 19, 2017: Children
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#20
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
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