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Related Concept Videos

Trachea01:22

Trachea

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The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
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Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
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Factors Affecting Pulmonary Ventilation01:19

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Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
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Tracheostomy Care I: Pre-procedural Steps01:16

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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
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Factors Affecting the Risk of Infection01:26

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
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Tracheostomy: Procedure and Tubes01:28

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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.
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Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs
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Modifiable and Non-Modifiable Risk Factors for Tracheostomy in Preterm Infants.

Brandon Dudeck1, Elias W Abebe2, Wendy Sun3

  • 1Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Pediatric Pulmonology
|February 13, 2025
PubMed
Summary

Unplanned extubations and postnatal steroid use increase tracheostomy risk in premature infants. Minimizing these factors can help reduce the need for tracheostomy in high-risk neonates.

Keywords:
Unplanned extubationpostnatal steroidstracheostomy placementtracheostomy risk factors

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Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Respiratory Medicine

Background:

  • Tracheostomy is a critical intervention for infants born before 33 weeks gestational age, often due to respiratory complications.
  • Identifying specific risk factors is crucial for proactive management and reducing tracheostomy rates.

Purpose of the Study:

  • To determine the risk factors associated with tracheostomy in preterm infants (born < 33 weeks gestational age).

Main Methods:

  • A retrospective matched case-control study was conducted involving infants born < 33 weeks gestational age who underwent tracheostomy.
  • Cases were matched with two controls based on gestational age and birth weight.
  • Data on mechanical ventilation duration, intubation/extubation events, steroid use, and Bronchopulmonary Dysplasia (BPD) severity were analyzed.

Main Results:

  • The study identified unplanned extubations and the number of postnatal steroid courses as independent risk factors for tracheostomy.
  • Other associated factors included male sex, outborn birth, intrauterine growth retardation, pulmonary hypertension, and sepsis.
  • Infants requiring tracheostomy experienced longer mechanical ventilation duration and hospital stays.

Conclusions:

  • Strategies aimed at reducing unplanned extubations and limiting postnatal steroid exposure are recommended to minimize tracheostomy risk in high-risk preterm infants.
  • Focusing on modifiable risk factors can improve outcomes for vulnerable neonates.