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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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Is Tracheostomy Insertion an Indication for Gastrostomy Insertion?

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    Most trauma and acute care surgery (ACS) patients needing tracheostomy also receive a gastrostomy tube during their hospital stay. Concomitant placement does not reduce hospital length of stay but may improve efficiency for patients requiring prolonged mechanical ventilation.

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    Area of Science:

    • Surgical outcomes
    • Critical care medicine
    • Trauma surgery

    Background:

    • Tracheostomy and gastrostomy are common procedures for patients requiring prolonged mechanical ventilation.
    • The optimal timing and approach for gastrostomy insertion in conjunction with tracheostomy are not well-defined.

    Purpose of the Study:

    • To determine the frequency of concomitant tracheostomy and gastrostomy insertion in surgical patients.
    • To compare hospital and ICU length of stay (LOS) between patients receiving concomitant versus delayed gastrostomy.

    Main Methods:

    • Retrospective review of trauma and acute care surgery (ACS) patients undergoing tracheostomy between 2006 and 2015.
    • Identification of patients who also underwent open or percutaneous endoscopic gastrostomy during the same hospitalization.
    • Data collection included demographics, hospital LOS, ICU LOS, and timing of procedures.

    Main Results:

    • 73% of tracheostomy patients underwent gastrostomy during the same admission.
    • 79% of patients with both tubes had them inserted concomitantly.
    • Median hospital LOS was 25 days for concomitant procedures versus 22 days for delayed/no gastrostomy (P=0.24).
    • 84% of patients on mechanical ventilation received tube feeds at discharge, with 78% not advanced to an oral diet.

    Conclusions:

    • The majority of trauma/ACS patients requiring tracheostomy also undergo gastrostomy during hospitalization.
    • Concomitant gastrostomy insertion is not associated with reduced hospital LOS.
    • Concomitant ICU gastrostomy may improve efficiency and cost-effectiveness for patients requiring prolonged mechanical ventilation and enteral nutrition.