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Related Concept Videos

Tracheostomy Decannulation01:21

Tracheostomy Decannulation

161
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...
161
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

551
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...
551
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

185
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:
185
Tracheostomy Care II: Procedure01:25

Tracheostomy Care II: Procedure

172
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...
172
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

874
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...
874
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

543
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
543

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Related Experiment Video

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Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
03:58

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes

Published on: August 2, 2024

661

Time considerations and outcomes in pediatric tracheostomy decannulation.

Ashley M Lloyd1, Hengameh K Behzadpour2, Md Sohel Rana3

  • 1Division of Otolaryngology, George Washington University Hospital, Washington, DC, USA.

International Journal of Pediatric Otorhinolaryngology
|March 27, 2024
PubMed
Summary

Pediatric tracheostomy decannulation is influenced by medical complexity and timely outpatient care. Factors like bronchopulmonary dysplasia and gastrostomy tubes impact decannulation duration, while early otolaryngology follow-up may expedite the process.

Keywords:
Bronchopulmonary dysplasiaDecannulationPediatric tracheostomyTracheostomy

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Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Healthcare Outcomes Research

Background:

  • Tracheostomy dependence in children presents significant challenges.
  • Understanding factors influencing decannulation is crucial for improving patient care and reducing healthcare burdens.

Purpose of the Study:

  • To identify key factors affecting the time to decannulation in pediatric patients (0-18 years) dependent on tracheostomy.
  • To inform clinical practice and family counseling regarding tracheostomy outcomes.

Main Methods:

  • Retrospective chart review of pediatric tracheostomy patients from 2005-2020.
  • Inclusion of demographic, socioeconomic, and clinical data.
  • Application of multivariate regression and survival analysis to identify predictors of decannulation.

Main Results:

  • Of 479 patients, 162 (33.8%) were decannulated, with a median time of 24 months.
  • Bronchopulmonary dysplasia and Passy-Muir® Valve use were associated with decannulation.
  • Neurologic comorbidities, gastrostomy tubes, and home ventilator use predicted prolonged tracheostomy.
  • Delayed outpatient otolaryngology care correlated with longer decannulation times.

Conclusions:

  • Pediatric tracheostomy decannulation is multifactorial, with medical complexity playing a significant role.
  • Timely establishment of outpatient otolaryngology care is associated with quicker decannulation.
  • Findings can guide institutional protocols and family expectations for tracheostomy management.