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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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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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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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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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Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

208
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

521
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 for COVID-19 Respiratory Failure: Multidisciplinary, Multicenter Data on Timing, Technique, and

Kamran Mahmood1, George Z Cheng2, Keriann Van Nostrand3

  • 1Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Duke University, Durham, NC.

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|May 24, 2021
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Summary

Early percutaneous tracheostomy in COVID-19 patients requiring mechanical ventilation led to better outcomes. This approach reduced ventilator days and intensive care unit stays compared to surgical tracheostomy.

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Area of Science:

  • Critical Care Medicine
  • Respiratory Medicine
  • Infectious Diseases

Background:

  • Tracheostomy is crucial for managing COVID-19 patients with respiratory failure needing prolonged mechanical ventilation.
  • Limited data exist on tracheostomy's impact on COVID-19 outcomes, with practice variations due to transmission concerns.

Purpose of the Study:

  • To assess the outcomes of tracheostomy in patients with COVID-19 respiratory failure.
  • To compare early versus late and percutaneous versus surgical tracheostomy techniques.

Main Methods:

  • Multicenter retrospective study of 118 COVID-19 patients undergoing tracheostomy across 5 academic medical systems.
  • Data collected on tracheostomy timing, technique (percutaneous vs. surgical), and patient outcomes.

Main Results:

  • Early tracheostomy (≤14 days) was linked to fewer ventilator days.
  • Percutaneous tracheostomy showed faster weaning, reduced ventilator-associated pneumonia, and shorter ICU/hospital stays compared to surgical tracheostomy.
  • No major procedural complications were reported.

Conclusions:

  • Early, percutaneous tracheostomy is associated with improved outcomes in ventilated COVID-19 patients.
  • This technique offers advantages over surgical tracheostomy regarding recovery time and complication rates.