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Related Concept Videos

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Physical Assessment of the Respiratory Tract II: Inspection01:27

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Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
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Peak inspiratory flow as predictor for tracheotomy.

M Lesnik1, J J Sanchez-Guerrero2, O De Crouy Chanel1

  • 1Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Pierre-et-Marie-Curie-Paris-VI, hôpital Tenon, assistance publique hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|July 5, 2017
PubMed
Summary

Peak inspiratory flow (PIF) can quantify severe airway obstruction in patients with acute dyspnea, aiding emergency tracheostomy decisions. This simple, non-invasive test helps determine the need for airway control surgery.

Keywords:
Acute upper airway obstructionHead and neck cancerInspiratory dyspneaPeak inspiratory flow (PIF)Tracheostomy

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Area of Science:

  • Medical Science
  • Respiratory Medicine
  • Oncology

Background:

  • Quantitative evaluation of upper airway obstruction is challenging during acute dyspnea, particularly in head and neck cancer (HNC) patients.
  • Decisions regarding airway control surgery can be difficult due to the lack of objective measures.
  • Peak inspiratory flow (PIF) has shown promise as a tool for assessing airway patency post-surgery.

Purpose of the Study:

  • To evaluate the role of PIF as a standardized, non-invasive tool for quantifying severe inspiratory dyspnea.
  • To assess the utility of PIF in guiding decisions for emergency tracheostomy in patients with upper airway obstruction.

Main Methods:

  • A prospective observational pilot study involving 22 patients with acute dyspnea due to upper airway obstruction.
  • PIF was measured using a hand-held PIF meter (In-Check method) before tracheotomy decisions were finalized.
  • Laryngeal fiberoscopy was performed, and obstruction severity was defined by PIF values.

Main Results:

  • PIF measurements were successfully obtained in all patients prior to tracheotomy.
  • PIF values below 53.1 L/min (18.3% of theoretical value) strongly correlated with the need for emergency tracheotomy.
  • This threshold aligns with previously established PIF values for decannulation feasibility.

Conclusions:

  • PIF serves as a reliable, non-invasive quantitative parameter for assessing upper airway obstruction severity.
  • PIF measurements can significantly aid in the clinical decision-making process for tracheostomy.
  • The PIF test is simple, rapid, and reproducible, making it a valuable bedside tool.