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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

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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.
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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...
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Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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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.
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Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

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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...
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Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

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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:
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Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

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Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
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Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

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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...
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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Tracheostomy after severe ischemic stroke: a population-based study.

Brian P Walcott1, Hooman Kamel2, Brandyn Castro3

  • 1Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 10, 2013
PubMed
Summary
This summary is machine-generated.

Tracheostomy is common in severe stroke patients undergoing decompressive craniectomy, with pneumonia being a key predictor. This highlights tracheostomy as a critical outcome in stroke care.

Keywords:
Brain edemabrain injuriesdecompressive craniectomyintracranial pressurestroketracheostomy

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Author Spotlight: Innovative Techniques and Future Directions in Stroke Research
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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Stroke frequently causes respiratory failure, sometimes necessitating tracheostomy for ventilation weaning or airway protection.
  • The incidence and predictors of tracheostomy in severe stroke patients remain poorly understood.
  • This study addresses the knowledge gap regarding tracheostomy rates after severe ischemic stroke.

Purpose of the Study:

  • To determine the rate of tracheostomy in patients hospitalized with severe ischemic stroke.
  • To compare tracheostomy rates between patients treated with and without decompressive craniectomy.
  • To identify predictors of tracheostomy following decompressive craniectomy.

Main Methods:

  • Analysis of the Nationwide Inpatient Sample database (2007-2009).
  • Identification of ischemic stroke patients using ICD-9-CM codes.
  • Stratification of patients based on decompressive craniectomy and determination of tracheostomy rates.
  • Logistic regression analysis to identify tracheostomy predictors after decompressive craniectomy.

Main Results:

  • A total of 1,550,000 ischemic stroke discharges were analyzed.
  • The overall tracheostomy rate was 1.3%; 1.3% for non-craniectomy patients and 33% for craniectomy patients.
  • Pneumonia was significantly associated with tracheostomy after decompressive craniectomy (OR, 3.95; 95% CI, 1.95-6.91).

Conclusions:

  • Tracheostomy is a frequent outcome for ischemic stroke patients who undergo decompressive craniectomy.
  • Pneumonia is a strong predictor of tracheostomy in this patient group.
  • Tracheostomy represents a significant patient-centered outcome warranting further investigation in stroke care.