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Novel Method for Sealing Tracheostomies Immediately after Decannulation-An Acute Clinical Feasibility Study
Rasmus Ellerup Kraghede1,2,3, Karen Juelsgaard Christiansen2, Alexander Emil Kaspersen2
1Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, 8200 Aarhus N, Denmark.
Biomedicines
|April 27, 2024
Summary
Sealing tracheostomy wounds with an intratracheal disc immediately after decannulation improves lung function and voice quality. This safe method enhances airway sealing and patient outcomes in intensive care unit settings.
Area of Science:
- Otolaryngology
- Pulmonology
- Critical Care Medicine
Background:
- Tracheostomy decannulation can result in an open airway passage, potentially causing pulmonary dysfunction and diminished voice quality.
- Effective sealing of the tracheostomy site is crucial for restoring normal airway function and improving patient communication.
- Current methods for managing the post-decannulation airway passage may be insufficient in ensuring adequate sealing.
Purpose of the Study:
- To assess the feasibility and immediate impact of using a novel intratracheal tracheostomy sealing disc.
- To evaluate the effect of this sealing method on laryngeal airflow and voice quality post-decannulation.
- To determine the safety and efficacy of this intervention in intensive care unit patients.
Main Methods:
- A prospective feasibility study involving 15 adult intensive care unit patients undergoing tracheostomy decannulation.
- Insertion of a temporary, silicone-based intratracheal sealing disc immediately after decannulation.
- Pulmonary function tests including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) were conducted.
- Voice quality was objectively assessed using a standardized rating scale.
Main Results:
- Significant improvements were observed in median FVC (883 mL to 1260 mL, p < 0.001) and FEV1 (790 mL to 870 mL, p < 0.001) after sealing.
- Voice quality scores showed a marked improvement, increasing from a median of 2 to 4 points (p < 0.001).
- Peak expiratory flow (PEF) did not show a statistically significant change (p = 0.720), indicating selective improvement in specific lung volumes.
Conclusions:
- Intratracheal tracheostomy sealing with a silicone disc is a feasible and safe procedure immediately following decannulation.
- This intervention leads to rapid improvements in key pulmonary function parameters (FVC, FEV1) and voice quality.
- The findings suggest a promising new approach for managing the airway post-decannulation to mitigate associated complications.
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