Related Experiment Video
Updated: Jun 26, 2026
04:43
Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
Published on: March 15, 2024
Pediatric tracheostomy in conjoined twins: multidisciplinary approach
Kyle Fisher1, Marc Thorne, Dinesh Choudhry
1Thomas Jefferson University Hospital, Department of Otolarynogology - Head and Neck Surgery, Philadelphia, PA 19107, USA. kylef9191@yahoo.com
International Journal of Pediatric Otorhinolaryngology
|January 23, 2009
Summary
Performing tracheostomy in conjoined twins requires a meticulous multidisciplinary strategy. This case report details the successful airway management of omphalopagus twins, highlighting key surgical and anesthetic considerations.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Neonatal Care
Background:
- Conjoined twins present unique challenges for airway management.
- Tracheostomy in conjoined twins is rarely reported, necessitating specialized approaches.
- Omphalopagus twins, joined ventrally, require careful planning for surgical interventions.
Purpose of the Study:
- To describe the multidisciplinary approach for tracheostomy in conjoined twins.
- To outline the anesthetic and surgical considerations for airway management in this rare population.
- To share insights into the postoperative care of conjoined twins undergoing tracheostomy.
Main Methods:
- A detailed literature search was conducted on tracheostomy in conjoined twins.
- A multidisciplinary team planned and rehearsed infant positioning for optimal cervical exposure.
- Individualized anesthetic teams and equipment were assigned to each twin.
- Specific protocols for transportation, intubation, and intraoperative airway management were developed.
- Postoperative tracheostomy care plans were established.
Main Results:
- The study reports the successful tracheostomy in 5.5-month-old omphalopagus conjoined twins.
- Key challenges including shared diaphragm ventilation and vascular supply were managed.
- Comprehensive planning and rehearsal facilitated successful surgical and anesthetic management.
- Postoperative care strategies were implemented effectively.
Conclusions:
- Tracheostomy in conjoined twins demands a highly coordinated, multidisciplinary effort.
- Careful preoperative planning, including rehearsals and individualized care, is crucial for success.
- This case highlights the feasibility of managing complex airway issues in conjoined twins.
Related Concept Videos
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:28Tracheostomy: Procedure and Tubes
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:25Tracheostomy Care II: Procedure
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
01:16Tracheostomy Care I: Pre-procedural Steps
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:21Tracheostomy Decannulation
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...