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Related Concept Videos

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

Oxygen Delivering System III: Tracheostomy and T-piece

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...
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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

Tracheostomy Care I: Pre-procedural Steps

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:
Tracheostomy Decannulation01:21

Tracheostomy Decannulation

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...
Endotracheal Intubation II: Nursing Management01:17

Endotracheal Intubation II: Nursing Management

Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals.

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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Tracheostomy vs. Delayed Extubation in Head and Neck Reconstruction: A Meta-Analysis.

Sahil Goel1,2, Christine Lee1, Ken Lin1

  • 1Department of Otolaryngology Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

The Laryngoscope
|March 19, 2026
PubMed
Summary
This summary is machine-generated.

Delayed extubation (DE) may be a safer alternative to tracheostomy for head and neck reconstruction patients, potentially reducing complications and hospital stays. This systematic review synthesizes evidence on DE versus tracheostomy outcomes.

Keywords:
airway managementextubationhead and neck cancerreconstructiontracheostomy

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Area of Science:

  • Head and Neck Surgery
  • Critical Care Medicine
  • Otolaryngology

Background:

  • High-volume centers are exploring delayed extubation (DE) as an alternative to tracheostomy in head and neck reconstruction.
  • This strategy aims to manage pharyngolaryngeal edema and ensure ventilation.
  • Evidence synthesis on DE versus tracheostomy is limited.

Purpose of the Study:

  • To conduct the largest systematic review and meta-analysis comparing delayed extubation (DE) with tracheostomy.
  • To evaluate effectiveness and outcomes in patients undergoing head and neck reconstruction.

Main Methods:

  • Systematic review of PubMed, Embase, and Scopus databases.
  • JBI methodology for systematic reviews of effectiveness.
  • Meta-analysis using Mantel-Haenszel method with risk ratios and 95% confidence intervals.

Main Results:

  • Delayed extubation (DE) was associated with shorter hospital (12.25 days) and ICU (1.47 days) stays compared to tracheostomy.
  • Meta-analysis showed significantly lower risk of airway complications (RR 4.14) and flap complications (RR 8.19) with DE.
  • Overall survival (95.7%) and disease-free survival (89.1%) were higher in the DE cohort.

Conclusions:

  • Tracheostomy is not always necessary and carries risks, necessitating shared decision-making.
  • Delayed extubation (DE) is a viable option for select head and neck reconstruction patients.
  • Further randomized controlled trials are needed to confirm these findings.