The role of tracheotomy in weaning.
Heffner JE.
SourceMedical University of South Carolina, Division of Pulmonary and Critical Care Medicine, Allergy, and Clinical Immunology, Charleston, SC, USA.
Abstract
Tracheotomy is commonly performed in ventilator-dependent patients. Disadvantages to the procedure are perioperative complications, long-term airway injury, and the cost of the procedure. Benefits ascribed to tracheotomy vs prolonged translaryngeal intubation include improved patient comfort, more effective airway suctioning, decreased airway resistance, enhanced patient mobility, increased potential for speech, ability to eat orally, a more secure airway, accelerated ventilator weaning, reduced ventilator-associated pneumonia, and the ability to transfer ventilator-dependent patients from the ICU. None of these benefits, however, have been demonstrated in large-scale, prospective, randomized studies. It is proposed that there should be an anticipatory approach wherein tracheotomy is considered after an initial period of stabilization with the patient receiving mechanical ventilation when it becomes apparent that the patient will require prolonged ventilator assistance. Tracheotomy then is performed when the patient appears likely to gain one or more of the benefits ascribed to the procedure.
Heffner JE.
SourceMedical University of South Carolina, Division of Pulmonary and Critical Care Medicine, Allergy, and Clinical Immunology, Charleston, SC, USA.
Abstract
Tracheotomy is commonly performed in ventilator-dependent patients. Disadvantages to the procedure are perioperative complications, long-term airway injury, and the cost of the procedure. Benefits ascribed to tracheotomy vs prolonged translaryngeal intubation include improved patient comfort, more effective airway suctioning, decreased airway resistance, enhanced patient mobility, increased potential for speech, ability to eat orally, a more secure airway, accelerated ventilator weaning, reduced ventilator-associated pneumonia, and the ability to transfer ventilator-dependent patients from the ICU. None of these benefits, however, have been demonstrated in large-scale, prospective, randomized studies. It is proposed that there should be an anticipatory approach wherein tracheotomy is considered after an initial period of stabilization with the patient receiving mechanical ventilation when it becomes apparent that the patient will require prolonged ventilator assistance. Tracheotomy then is performed when the patient appears likely to gain one or more of the benefits ascribed to the procedure.
Mon May 08, 2023 3:14 pm by yagocom
» ultrasound of lung in critical care patients
Mon Apr 24, 2023 9:50 am by yagocom
» respiratory diseases , anaesthetic management 2023
Sat Feb 18, 2023 6:42 pm by yagocom
» thoracic anaesthesia 2023
Fri Feb 10, 2023 10:43 pm by yagocom
» indication to SICU admission
Sun Nov 20, 2022 3:21 pm by yagocom
» electrolyte disturbances
Sat Jul 23, 2022 11:11 pm by yagocom
» fluid physiology
Mon Jul 11, 2022 12:09 pm by yagocom
» TAP block USG
Mon Jul 11, 2022 11:56 am by yagocom
» Assisted ventilation for surgical patients
Fri Jul 08, 2022 10:40 am by yagocom
» nutrition in critical ill patient
Sun Jun 12, 2022 11:14 pm by yagocom
» US workshop in Mosul
Fri May 27, 2022 2:56 pm by yagocom
» Basics of ultrasound
Fri May 27, 2022 2:28 pm by yagocom
» الملتقى العلمي الاول للجمعية العراقية للتخدير والعناية المركزة والحد من الالم فرع الموصل
Mon May 09, 2022 7:15 pm by yagocom
» Geriatric anaesthesia
Sun May 08, 2022 10:35 pm by yagocom
» thoracic anaesthesia 2022
Sat Jan 15, 2022 11:14 pm by yagocom
» chronic pain management
Fri Dec 03, 2021 5:53 pm by yagocom
» anaesthesia in respiratory diseases
Mon Nov 29, 2021 8:33 pm by yagocom
» anaesthesia for plastic procedures
Mon Jul 19, 2021 11:17 am by yagocom
» ECG for candidate
Mon Jul 19, 2021 11:14 am by yagocom
» postoperative care
Tue Feb 23, 2021 10:50 pm by yagocom