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Percutaneous tracheostomy tube obstruction: warning.

Steven J Trottier1, Steven Ritter, Rekha Lakshmanan

  • 1Department of Critical Care Medicine, St. John's Mercy Medical Center, St. Louis University, Tower B 4006, 621 South New Ballas Road, St. Louis, MO 63141, USA. trotsj@stlo.smhs.com

Chest
|October 16, 2002
PubMed
Summary
This summary is machine-generated.

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Modified Portex tracheostomy tubes significantly reduced airway obstruction compared to standard tubes. Researchers recommend using the modified version to prevent complications in ICU patients.

Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Surgical Innovation

Background:

  • Percutaneous dilatational tracheostomy is a common procedure in intensive care units.
  • Standard Portex Per-fit tracheostomy tubes are frequently used, but their patency can be a concern.
  • Airway obstruction due to tracheostomy tube occlusion can lead to significant patient morbidity.

Purpose of the Study:

  • To evaluate and compare the patency of standard and modified Portex Per-fit tracheostomy tubes.
  • To assess the incidence of airway obstruction in patients receiving these tubes.
  • To determine if modifications to the standard tube improve patency and reduce obstruction.

Main Methods:

  • A prospective observational study was conducted in medical-surgical ICUs.

Related Experiment Videos

  • Patients requiring tracheostomy were divided into two groups: standard Portex (Group 1) and modified Portex (Group 2).
  • Fiberoptic evaluations were performed daily for 72 hours post-insertion to assess tube patency and obstruction.

    • Main Results:

    • The modified Portex tube group showed significantly less partial occlusion (>25%) compared to the standard group (6% vs. 57%).
    • Severe occlusion (>40%) was observed in 41% of the standard tube group, versus 0% in the modified group.
    • Clinical signs of airway obstruction were present in one patient with the standard tube, and none with the modified tube.

    Conclusions:

    • The standard Portex Per-fit tracheostomy tube is associated with a high rate of partial airway obstruction.
    • Modifications to the Portex tracheostomy tube significantly decrease the incidence of airway obstruction.
    • The study recommends discontinuing the use of the standard Portex Per-fit tube and adopting the modified version.