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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.
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...
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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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Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

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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,...
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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.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
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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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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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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications
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Characterizing mortality in pediatric tracheostomy patients.

Jamie L Funamura1, Sonia Yuen1, Kosuke Kawai1,2

  • 1Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.

The Laryngoscope
|November 4, 2016
PubMed
Summary

Pediatric tracheostomy patients face high mortality risks, particularly those with cardiopulmonary conditions. Most deaths occur post-hospitalization, with bronchopulmonary dysplasia and congenital heart disease being key predictors.

Keywords:
Pediatric tracheostomybronchopulmonary dysplasiacongenital heart diseasetracheostomy indication

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Area of Science:

  • Pediatric critical care medicine
  • Respiratory medicine
  • Surgical outcomes research

Background:

  • Tracheostomy is a vital procedure for pediatric patients with airway compromise or respiratory failure.
  • Longitudinal data on mortality risk following pediatric tracheostomy is limited.
  • Understanding risk factors is crucial for improving patient management and outcomes.

Purpose of the Study:

  • To evaluate the long-term risk of death in children undergoing tracheostomy.
  • To identify demographic and clinical factors associated with mortality after tracheostomy.
  • To determine the timing of death relative to the tracheostomy procedure.

Main Methods:

  • Retrospective cohort study of 513 pediatric patients (≤18 years) who underwent tracheostomy.
  • Data collected from hospital records between 1984 and 2015.
  • Statistical analysis included Cox proportional hazards models to assess mortality risk.

Main Results:

  • The median age at tracheostomy was 0.8 years.
  • The highest mortality rate (27.8%) was observed in adolescents (13-18 years).
  • Cardiopulmonary indications (adjusted hazard ratio: 3.53) and conditions like bronchopulmonary dysplasia (aHR: 2.63) and congenital heart disease (aHR: 2.61) significantly increased mortality risk.

Conclusions:

  • Pediatric tracheostomy is associated with substantial long-term mortality.
  • Cardiopulmonary disease as an indication for tracheostomy is a major risk factor.
  • Bronchopulmonary dysplasia and congenital heart disease are independent predictors of mortality in this population.