Search Our Scientific Publications & Authors

JA Clin Rep 2020 May 22;6(1):37. Epub 2020 May 22.

Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.

Background: Tracheo-innominate artery fistula (TIF) is a life-threatening complication of tracheostomy. We describe perioperative management for innominate artery transection in a case with TIF.

Case Presentation: A 4-year-old Japanese female with Marshal-Smith syndrome presented for management of TIF. Read More

ANZ J Surg 2020 May 17. Epub 2020 May 17.

Department of Otolaryngology-Head and Neck Surgery, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.

Background: Tracheostomy-tube change protocols are implemented primarily due to concern regarding infections. Currently changes vary from within 4 weeks post-insertion to 3 monthly thereafter. However, currently no evidence-based guidelines exist to justify these protocols. Read More

Otolaryngol Head Neck Surg 2020 May 12:194599820928963. Epub 2020 May 12.

Anesthesiology and Intensive Care Unit, University of Insubria, Varese, Italy.

The COVID-19 outbreak poses continued struggles due to the unprecedented number of patients admitted to intensive care units and the overwhelming need for mechanical ventilation. We report a preliminary case series of 32 patients with COVID-19 who underwent elective tracheostomies after a mean intubation period of 15 days (range, 9-21 days). The procedure was performed with percutaneous (10 cases) and open (22 cases) surgical techniques. Read More

Am J Otolaryngol 2020 Mar - Apr;41(2):102376. Epub 2019 Dec 24.

Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA. Electronic address:

Purpose: Develop a model for quality improvement in tracheostomy care and decrease tracheostomy-related complications.

Methods: This study was a prospective quality improvement project at an academic tertiary care hospital. A multidisciplinary team was assembled to create institutional guidelines for clinical care during the pre-operative, intra-operative, and post-operative periods. Read More

Indian J Otolaryngol Head Neck Surg 2019 Oct 23;71(Suppl 1):852-854. Epub 2019 Jan 23.

Department of Anaesthesia, PGIMER, Chandigarh, India.

Tracheostomy tube change is a relatively common procedure once a tracheo-cutaneous tract matures. Regular tracheostomy tube changes prevent the formation of granulation tissue and reduce bacterial colonization (Yaremchuk and Yaremchuk in Laryngoscope 113(1):1-10, 2003). However, serious complications such as subcutaneous emphysema, loss of airway and mediastinitis, can occur if the tube exchange is performed inappropriately. Read More

Health Technol Assess 2019 Sep;23(48):1-114

Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

Background: Invasive mechanical ventilation (IMV) is a life-saving intervention. Following resolution of the condition that necessitated IMV, a spontaneous breathing trial (SBT) is used to determine patient readiness for IMV discontinuation. In patients who fail one or more SBTs, there is uncertainty as to the optimum management strategy. Read More

Laryngoscope 2020 May 6;130(5):1249-1255. Epub 2019 Aug 6.

The Johns Hopkins Hospital, Baltimore, Maryland, U.S.A.

Objective: The primary objective of our study was to determine the quality of life (QOL) using a talking tracheostomy tube.

Methods: Randomized clinical trial (NCT2018562). Adult intensive care unit patients who were mechanically ventilated, awake, alert, attempting to communicate, English-speaking, and could not tolerate one-way speaking valve were included. Read More

Laryngoscope 2020 May 22;130(5):1316-1321. Epub 2019 Jun 22.

Department of ENT, Christian Medical College, Vellore, India.

Objective: Age-based formulas for selecting the appropriate size of tracheostomy tubes in children are based on data on tracheal dimensions. This study aims to measure the tracheal dimensions of Indian children by computerized tomography (CT) and to compare this with the dimensions of age-appropriate tracheostomy tubes.

Methods: CT scans of children aged less than 16 years that were taken for indications other than respiratory distress were included. Read More

Int J Pediatr Otorhinolaryngol 2019 May 8;120:78-81. Epub 2019 Feb 8.

Department of Pediatric Otorhinolaryngology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.

Objectives: The first tracheostomy tube change is typically performed on days 5-7 post-operatively, however recent international consensus guidelines suggested that, with maturation sutures, days 3-5 is appropriate. We evaluate whether a first tube change on day 2 post-operatively is safe and effective.

Methods: We carried out a retrospective review of all patients undergoing tracheostomy between 2009 and 2018. Read More

JAMA Netw Open 2019 01 4;2(1):e187851. Epub 2019 Jan 4.

Fostering Improvement in End-of-Life Decision Science, University of Pennsylvania, Philadelphia.

Importance: Patients with serious illnesses are often encouraged to actively deliberate about the desirability of life support. Yet it is unknown whether deliberation changes the substance or quality of such decisions.

Objective: To identify differences in decisions about life support interventions and goals of care made intuitively vs deliberatively by patients with serious illnesses. Read More

J Pediatr Nurs 2019 Mar - Apr;45:7-12. Epub 2018 Dec 19.

Department of Nursing, Xin Hua Hospital Affiliated to Shang Hai Jiao Tong University School of Medicine, Shanghai, China.

Purpose: The number of pediatric patients who require a long-term tracheal tube at home is gradually increasing. Studies have demonstrated that the parents of these children report high levels of stress, anxiety and other negative emotions as early as shortly after discharge from the hospital. The purpose of this study is to describe the home care experiences of parents of children with tracheostomies during the transition from hospital to home in China to more effectively address their needs. Read More

Front Med (Lausanne) 2018 19;5:264. Epub 2018 Sep 19.

Department of Anesthesiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Surgery for laryngeal cancer and the following recurrent tumor growth may further change the anatomy of the airway. Airway management during anesthesia induction is challenging for the patients undergoing secondary surgery due to recurrence of laryngeal cancer or its postoperative complication, but it has never been reported. In this report, we described three cases of anesthetic induction which had different process of airway events. Read More

J Pediatr 2018 12 17;203:354-360.e1. Epub 2018 Sep 17.

Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC.

Objective: To describe the perceptions of caregivers of children with medical complexity (CMC) about their decision to pursue tracheostomy for their children, in particular the satisfaction with their decision.

Study Design: In this qualitative study conducted in western North Carolina between 2013 and 2014, we interviewed 56 caregivers of 41 CMC who had received tracheostomies in the past 5 years. Three of the CMC were deceased at the time of the interview; 8 were decannulated. Read More

Anesth Analg 2019 10;129(4):1061-1068

Department of Anesthesiology and Pediatrics, Duke University School of Medicine, Durham, North Carolina.

Background: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to perceived benefits of less postoperative sedation and a lower risk for accidental extubation. This study sought to describe the practice of nasal intubation in the pediatric population undergoing cardiopulmonary bypass surgery and assess the risks/benefits of a nasal route against an oral one. Read More

Infect Control Hosp Epidemiol 2018 10 31;39(10):1222-1229. Epub 2018 Aug 31.

Division of Infectious Diseases and Hospital Epidemiology,University Hospital Zürich,University of Zurich,Zurich,Switzerland.

Objective: Preventing ventilator-associated pneumonia (VAP) is an important goal for intensive care units (ICUs). We aimed to identify the optimal behavior leverage to improve VAP prevention protocol adherence.

Design: Mixed-method study using adherence measurements to assess 4 VAP prevention measures and qualitative analysis of semi-structured focus group interviews with frontline healthcare practitioners (HCPs). Read More

Pediatr Pulmonol 2018 09 3;53(9):1237-1244. Epub 2018 Jul 3.

Division of Neonatology and Department of Pediatrics, The Children's Hospital of Philadelphia and The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Objectives: To examine growth, sedation needs, and participation in developmental activities before and after tracheostomy among infants with severe bronchopulmonary dysplasia.

Methods: Retrospective analysis of infants born at <32 weeks' gestation or birth weights <1500 g with severe BPD who underwent tracheostomy placement between January 1, 2010 and December 31, 2016 in a quaternary referral newborn and infant intensive care unit. Changes in growth parameters and frequency/type of participation in physical therapy sessions performed during the 4-weeks before tracheostomy and 4-weeks after the first tracheostomy tube change were compared. Read More

Dysphagia 2018 12 18;33(6):857-865. Epub 2018 Jun 18.

Department of Physical Medicine and Rehabilitation, Catholic University of Korea, Daejeon St. Mary's Hospital, Daejeon, 34943, Republic of Korea.

We investigated the functional changes in swallowing and voluntary coughing before and after tracheostomy decannulation among stroke patients who had undergone a tracheostomy. We also compared these functions between stroke patients who underwent tracheostomy tube removal and those who did not within 6 months of their stroke. Seventy-seven stroke patients who had undergone a tracheostomy were enrolled. Read More

J Bronchology Interv Pulmonol 2018 Oct;25(4):343-345

Pediatric Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Nasogastric tubes have been used in the pediatric age group to supplement nutrition in cases of malignancy and failure to thrive due to a variety of causes. Breathing difficulty may occur after the insertion of a nasogastric tube and it can have multiple causes. Here we discuss 2 patients of acute lymphoblastic leukemia (ALL) who developed a rare condition called the Sofferman syndrome (nasogastric tube syndrome). Read More

Intensive Crit Care Nurs 2018 Jun 16;46:10-16. Epub 2018 Mar 16.

Faculty of Health Sciences University of Sydney, Australia.

Objectives: A tracheostomy tube can profoundly impact ability to communicate. The impact of this on patients' self-esteem and quality of life in the care continuum from the intensive care unit to after decannulation has not been reported. Therefore, the aim was to investigate the patient-reported experience regarding change in communication function, communication-related self-esteem and quality of life. Read More

J Trauma Acute Care Surg 2018 07;85(1):135-139

From the Department of Surgery (J.M., J.P.H., J.G., J.P., N.F.), Cooper University Hospital, Camden, New Jersey; Rowan University (C.A.), Glassboro, New Jersey; Department of Surgery (M.D.), St. Barnabas Medical Center, Livingston, NJ; Department of Surgery (A.P), Lancaster General Hospital, Lancaster, Pennsylvania; Jefferson Medical School (L.N.), Philadelphia.

Background: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long-term SFTs. Read More

Anesth Essays Res 2017 Oct-Dec;11(4):964-968

Department of Anaesthesiology, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India.

Background: Tracheostomy tube (TT) change is the common procedure in trauma Intensive Care Unit (ICU) and almost always associated with cough reflex, increase in blood pressure, and heart rate. Dexmedetomidine (DEX) is a selective α-adrenergic receptor agonist well studied for the prevention of pressor response during laryngoscopy and extubation, but literature on prevention of pressor response during TT change is lacking.

Aims: The aim of this study is to compare two doses (0. Read More

Cureus 2017 Jul 18;9(7):e1489. Epub 2017 Jul 18.

Surgery, Harlem Hospital Center.

Tracheostomy tube change is a relatively common and simple procedure once a tract is formed between the skin and the trachea. Regular tracheostomy tube changes decrease the risk of postoperative pulmonary infection and granulation tissue formation. However, serious complications, such as loss of airway, subcutaneous emphysema, and mediastinitis, can occur if the tube exchange is performed inappropriately. Read More

Int J Pediatr Otorhinolaryngol 2017 Aug 6;99:107-110. Epub 2017 Jun 6.

Massachusetts Eye and Ear, Boston, MA, United States; Massachusetts General Hospital for Children, Boston, MA, United States.

Importance: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. Read More

Int J Pediatr Otorhinolaryngol 2017 Jun 31;97:235-239. Epub 2017 Mar 31.

Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road #4000, Columbus, OH 43212, USA; Department of Pediatric Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address:

Objective: Tracheotomy-related pressure wounds have been reported as high as 29%. All advanced stage (stage 3 or 4) wounds are reported by hospitals, and CMS will no longer reimburse healthcare costs to manage them. We present the results of an intensive, multidisciplinary wound prevention strategy starting in the operating room at the time of tracheotomy placement. Read More

Plast Reconstr Surg 2017 Apr;139(4):975e-983e

Columbus, Ohio From the Department of Plastic Surgery, The Ohio State University College of Medicine; and the Department of Plastic and Reconstructive Surgery, the Department of Speech Pathology, and the Sleep Disorder Center, Division of Pulmonary Medicine, Nationwide Children's Hospital.

Background: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion. Read More

Saudi J Anaesth 2017 Jan-Mar;11(1):99-101

Department of Anaesthesiology, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India.

Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Read More

Cochrane Database Syst Rev 2017 01 10;1:CD011776. Epub 2017 Jan 10.

Department of Rehabilitation Medicine, Royal Melbourne Hospital, Royal Park Campus, Poplar Road, Parkville, Melbourne, Victoria, Australia, 3052.

Background: Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited.

Objectives: To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND.

Methods: We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND. Read More

J Pain Symptom Manage 2017 02 15;53(2):178-187.e1. Epub 2016 Nov 15.

Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; James J. Peters Veterans Affairs Medical Center, Bronx, New York.

Context: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression.

Objectives: The objective of this study was to determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses.

Methods: We used data from the Health and Retirement Study, a longitudinal survey of U. Read More

J Intensive Care Med 2018 Jul 16;33(7):420-423. Epub 2016 Nov 16.

1 Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.

Background: Ankylosing spondylitis (AS) is a common disease with an incidence of approximately 0.5% in Europe, causing severe limitations of axial spine mobility and cervical kyphosis. Deformities of the cervical spine and the temporomandibular joints could increase the risk of complications while performing an intubation or tracheostomy. Read More

J Crit Care 2017 02 4;37:173-178. Epub 2016 Jun 4.

Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.

Purpose: Few guidelines exist regarding the selection of a particular type or size of tracheostomy tube. Although nonstandard tubes can be placed over the percutaneous kit dilator, clinicians often place standard tracheostomy tubes and change to nonstandard tubes only after problems arise. This practice risks early tracheostomy tube change, possible bleeding, or loss of the airway. Read More

Int J Pediatr Otorhinolaryngol 2016 Nov 27;90:54-57. Epub 2016 Aug 27.

University of Michigan Health System, Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Ann Arbor, MI, United States.

Introduction: With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it.

Objective: We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant. Read More

Indian J Crit Care Med 2016 Aug;20(8):448-52

Department of Anesthesia Critical Care and Pain, Division of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.

Background: The transport of critically ill patients for procedures or tests outside the Intensive Care Unit (ICU) is potentially hazardous; hence, the transport process must be organized and efficient. Plenty of data is available on pre- and inter-hospital transport of patients; the data on intrahospital transport of patients are limited. We audited the complications and benefits of intrahospital transport of critically ill patients in our tertiary care center over 6 months. Read More

Am J Phys Med Rehabil 2017 Apr;96(4):268-272

From the Schoen Klinik Bad Aibling, Bad Aibling, Germany.

Objective: Tracheostomy tubes (TT) are often needed in patients with severe neurologic injuries to protect the respiratory system from aspiration. However, TTs alter physiological oral-nasal airflow and are suspected to influence the pattern of pharyngeal swallowing. The aim of this work was to evaluate the effect of TT occlusion on pharyngeal swallowing physiology and to determine penetration-aspiration (PA) values of open versus closed TTs in neurogenic dysphagia. Read More

Cochrane Database Syst Rev 2016 Jul 20;7:CD008045. Epub 2016 Jul 20.

Department of Anaesthesiology, Intensive Care Medicine, and Pain Therapy, HELIOS Klinikum Krefeld, Lutherplatz 40, Krefeld, Germany, 47805.

Background: Tracheostomy formation is one of the most commonly performed surgical procedures in critically ill intensive care participants requiring long-term mechanical ventilation. Both surgical tracheostomies (STs) and percutaneous tracheostomies (PTs) are used in current surgical practice; but until now, the optimal method of performing tracheostomies in critically ill participants remains unclear.

Objectives: We evaluated the effectiveness and safety of percutaneous techniques compared to surgical techniques commonly used for elective tracheostomy in critically ill participants (adults and children) to assess whether there was a difference in complication rates between the procedures. Read More

Disabil Rehabil 2017 06 23;39(12):1162-1170. Epub 2016 Jun 23.

a Physical Therapy and Rehabilitation Clinic, Ministry of Health Ankara Diskapi Yildirim Beyazit Education and Research Hospital , Ankara , Turkey.

Purpose: Following repeated weaning failures in acute care services, spinal cord injury (SCI) patients who require prolonged mechanical ventilation and tracheostomy are discharged to their homes or skilled nursing facilities, with a portable mechanical ventilator (MV) and/or tracheostomy tube (TT) with excess risk of complications, high cost and low quality of life. We hypothesized that many difficult-to-wean patients with cervical SCI can be successfully managed in a rehabilitation clinic. The aim of our study was to develop a respiratory rehabilitation, MV weaning and TT decannulation protocol and to evaluate the effectiveness of this protocol in tetraplegic patients. Read More

Nurs Stand 2016 Mar;30(30):34-6

University of Hull, Hull, England.

RATIONALE AND KEY POINTS: Proactive tracheostomy management increases patient safety and reduces adverse events. ▶ A cleaning regimen performed every four hours reduces the risk of a blocked tracheostomy cannula, complete tube occlusion and respiratory arrest. ▶ Sterile tracheostomy dressings allow secretions from the stoma to be absorbed and prevent pressure damage from the tracheostomy tube. Read More

Can J Respir Ther 2016 ;52(1):7-11

Quality Department, Trillium Health Partners, Mississauga, Ontario.

Background: Percutaneous tracheostomy is a common procedure in the intensive care unit and, on patient transfer to the wards, there is a gap in ongoing tracheostomy management. There is some evidence that tracheostomy teams can shorten weaning to decannulation times. In response to lengthy weaning to decannulation times at Trillium Health Partners - Credit Valley Hospital site (Mississauga, Ontario), an interprofessional tracheostomy team, led by respiratory therapists and consisting of speech-language pathologists and intensive care physicians, was implemented. Read More

Respir Care 2016 May 9;61(5):607-14. Epub 2016 Feb 9.

School of Medicine, Flinders University, Adelaide, South Australia, Australia and the Intensive Care Unit, Flinders Medical Centre, Adelaide, South Australia, Australia.

Background: Advancements in tracheostomy tube design now provide clinicians with a range of options to facilitate communication for individuals receiving ventilator assistance through a cuffed tube. Little is known about the impact of these modern design features on resistance to air flow.

Methods: We undertook a bench model test to measure pressure-flow characteristics and resistance of a range of tubes of similar outer diameter, including those enabling subglottic suction and speech. Read More

Crit Care Med 2016 Jun;44(6):1075-81

1Department of Speech Pathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia. 2Department of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia. 3National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia. 4Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, Australia. 5Department of Intensive Care, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

Objectives: A cuffed tracheostomy tube facilitates prolonged mechanical ventilation and weaning but usually leads to prolonged voicelessness, which can be one of the most negative experiences of hospitalization. No randomized trials have examined the effects of targeted early communication intervention for the restoration of voice in ventilated tracheostomy patients in the ICU.

Design: A prospective randomized clinical trial. Read More

Respir Med Case Rep 2015 12;16:11-4. Epub 2015 Jun 12.

Department of Internal Medicine, Division of Pulmonary & Critical Care, Carver College of Medicine, University of Iowa Health Care, USA.

A patient presents with a new bronchogenic carcinoma 5 years after laryngectomy for recurrent laryngeal tumor and 13 years after chemoradiation for concurrent lung cancer with synchronous base-of-tongue tumor. Due to his complex history and perceived limited respiratory reserve, he was felt high risk for the completion pneumonectomy needed for resection of this new tumor. The attending surgeon requested a full cardiopulmonary exercise test for risk assessment prior to surgery. Read More

J Laryngol Otol 2016 Apr 28;130(4):388-92. Epub 2015 Dec 28.

Department of Intensive Care,Kovai Medical Center and Hospital,Coimbatore,India.

Objective: To compare the outcomes of two types of tracheostomy tubes used in major head and neck surgery.

Methods: A retrospective study was conducted of prospectively collected data. The post-operative safety and adequacy of a single cannula tracheostomy tube was compared to a double cannula tracheostomy tube in patients undergoing tracheostomy during major oral and oropharyngeal resections. Read More

Pediatr Pulmonol 2016 07 17;51(7):696-704. Epub 2015 Dec 17.

Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Objective: The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. Read More

Ann Vasc Surg 2016 Feb 17;31:206.e9-206.e12. Epub 2015 Nov 17.

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Radiology Institute, Interventional Radiology Department, São Paulo, Brazil.

A 4-year-old boy presented with acute and profuse bleeding at the tracheostomy site. An emergency angiography was performed and identified a pseudoaneurysm at the innominate artery. A selective catheterization of the artery was executed and 2 Advanta V12 balloon-expandable covered stents were implanted in an overlapping manner to occlude the pseudoaneurysm. Read More

PLoS One 2015 17;10(9):e0138294. Epub 2015 Sep 17.

Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, National Taiwan University Hospital, Taipei, Taiwan (R.O.C).

Background And Objective: Weaning parameters are commonly measured through an endotracheal tube in mechanically ventilated patients recovering from acute respiratory failure, however this practice has rarely been evaluated in tracheostomized patients. This study aimed to investigate changes in weaning parameters measured before and after tracheostomy, and to explore whether the data measured after tracheostomy were associated with weaning outcomes in difficult-to-wean patients.

Methods: In a two-year study period, we enrolled orotracheally intubated patients who were prepared for tracheostomy due to difficult weaning. Read More

Respir Care 2015 Dec 18;60(12):1749-58. Epub 2015 Aug 18.

Pulmonology Section, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas and the Pediatric Aerosol Research Laboratory, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.

Background: Some pediatric patients receiving therapeutic aerosols undergo tracheostomy, and others who are tracheostomized continue requiring inhaled therapies upon decannulation. It is unknown whether a dose adjustment is required. Different devices are available for facial and tracheostomy delivery, and in some instances, the assisted technique is used. Read More

Nurs Crit Care 2017 Mar 15;22(2):81-88. Epub 2015 Jul 15.

Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.

Background: There is a change in paradigm in intensive care units with trends towards lighter sedation. Light or no sedation protocols are, however, a radical change for clinical practice and can cause challenges for the patients. Undergoing mechanical ventilation when conscious can be a distressing experience for the patients. Read More

Am Surg 2015 Apr;81(4):345-8

Department of Surgery, The University of Virginia Health System, Charlottesville, Virginia, USA.

The purpose of this study was to evaluate the usefulness of chest radiography in the direction of postbronchoscopy clinical therapy. From 2001 to 2011, 368 rigid bronchoscopies were performed at a single institution in 221 children. Indications for bronchoscopy, concomitant bronchoscopic procedures, and results of postoperative chest radiography were evaluated. Read More

Anesth Pain Med 2014 Oct 10;4(4):e18280. Epub 2014 Sep 10.

Cardiac Anesthesia Research Center, Imam-Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: Lung isolation is a common technique used in thoracic surgery to prevent spillage to unaffected lung and to provide a better view for the surgeon.

Case Presentation: A 41-year-old woman with a history of pharyngo-laryngo-oesophagectomy (PLO) and tracheostomy was a candidate for thoracic duct ligation because of chylothorax. Since the patient had tracheostmy stomal stenosis, two cuffed tracheal tubes (internal diameter = 4. Read More

JA Clin Rep 2015 16;1(1):16. Epub 2015 Oct 16.

Department of Anesthesiology, Kitasato University, School of Medicine, 1-15-1, Kitasato, Minamiku, Sagamihara, Kanagawa Japan 2520374.

We report three cases of airway management with elective surgical cricothyroidotomy (SCT) for anesthetic management during surgical repair of maxillofacial injury involving basal skull fracture or nasal-bone fracture. In all patients, general anesthesia was induced, a supraglottic airway (SGA) device inserted, and SCT performed. Tracheal intubation was performed through SCT site, and the SGA device was removed. Read More