9,256 results match your criteria patients tracheostomy

Functional Outcomes, Goals, and Goal Attainment Amongst Chronically Critically Ill Long-Term Acute Care Hospital Patients.

Ann Am Thorac Soc 2021 May 13. Epub 2021 May 13.

University of Pennsylvania Perelman School of Medicine, 14640, Philadelphia, Pennsylvania, United States.

Rationale: Chronically critically ill patients admitted to a long-term acute care hospital (LTACH) setting are a vulnerable population of intensive care unit survivors. Little is known of the goals and functional outcomes achieved by patients after rehabilitation in the LTACH setting.

Objectives: We sought to examine patient goals and functional outcomes, including swallowing function, amongst ICU survivors admitted to an LTACH with a tracheostomy. Read More

View Article and Full-Text PDF

Variable phenotypes in congenital central hypoventilation syndrome with PHOX2B nonpolyalanine repeat mutations.

J Clin Sleep Med 2021 May 13. Epub 2021 May 13.

Department of Pediatrics, Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, Los Angeles, CA.

Study Objectives: Congenital central hypoventilation syndrome (CCHS) is a rare disorder affecting the autonomic nervous system that is caused by variants in the PHOX2B gene. About 10% of patients with CCHS have nonpolyalanine repeat mutations (NPARM) that are associated with severe phenotypes requiring continuous assisted ventilation, Hirschsprung's disease, and increased neural crest tumor risk. However, some patients with NPARMs have milder phenotypes. Read More

View Article and Full-Text PDF

The key role of 3D printing and the new medical sterilizable threads in the development of the translaryngeal Tracheostomy Needle Introducer.

3D Print Med 2021 May 12;7(1):14. Epub 2021 May 12.

Department of Emergency and Intensive Care, ASST-Monza, Monza, Italy.

Background: Percutaneous tracheostomy is frequently performed in intensive care units in patients who require prolonged mechanical ventilation. The first crucial step for the physician in these procedures is the precise needle insertion into the trachea. The primary aim of this technical note was to test the new filament and share our experiences in the implementation of the new device. Read More

View Article and Full-Text PDF

Use of continuous intercostal nerve blockade is associated with improved outcomes in patients with multiple rib fractures.

Trauma Surg Acute Care Open 2021 26;6(1):e000600. Epub 2021 Apr 26.

Surgery, The University of Alabama at Birmingham, Birmingham, Alabama, USA.

Background: Rib fractures are common among trauma patients and may result in significant morbidity and mortality. There are numerous treatment options, but ideal management is unclear. Delivery of local anesthetic via an analgesia catheter for continuous intercostal nerve blockade offers an attractive potential option for management of patients with rib fractures. Read More

View Article and Full-Text PDF

Surgical Treatment Outcomes of Acquired Benign Tracheoesophageal Fistula: A Literature Review.

J Chest Surg 2021 May 12. Epub 2021 May 12.

Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Yangsan, Korea.

Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques.

Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. Read More

View Article and Full-Text PDF

Pulmonary Support of Infants with Tracheotomies in a Regional Neonatal Intensive Care Unit.

Am J Perinatol 2021 May 11. Epub 2021 May 11.

Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.

Objective:  We evaluate patient characteristics, hospital course, and outcome by type discharge pulmonary support; mechanical ventilation (MV) or with tracheotomy masks (TM).

Study Design:  We reviewed records of infants admitted to the neonatal intensive care unit (NICU) that underwent tracheotomy within their first year of life between 2006 and 2017. We evaluated patient characteristics, referral pattern, destination of discharge, and outcome by type of pulmonary support at discharge (MV vs. Read More

View Article and Full-Text PDF

Subglottic and tracheal stenosis associated with coronavirus disease 2019.

J Laryngol Otol 2021 May 11:1-3. Epub 2021 May 11.

ENT - Head and Neck Department, Royal London Hospital, Barts NHS Healthcare Trust, London, UK.

Background: Coronavirus disease 2019 critical care patients endure prolonged periods of intubation. Late tracheostomy insertion, large endotracheal tubes and high cuff pressures increase their risk of subglottic and tracheal stenosis. This patient cohort also often appears to have co-morbidities associated with laryngotracheal stenosis, including high body mass index and laryngopharyngeal reflux. Read More

View Article and Full-Text PDF

Bacterial Biofilms on Tracheostomy Tubes.

Indian J Otolaryngol Head Neck Surg 2021 May 6:1-5. Epub 2021 May 6.

Department of Otorhinolaryngology, Yenepoya Medical College, Mangalore, Karnataka India.

Tracheostomy is a commonly performed airway surgery for critically ill patients. Tracheostomy tube is an indwelling prosthesis, providing potential surface for growth of bacteria. Biofilm formation by bacteria as a self-protective mechanism, has led to worrisome antibacterial resistance and thus higher rate of nosocomial infections. Read More

View Article and Full-Text PDF

Early Tracheostomy in Morbidly Obese COVID-19 Patients: A Case Series and Discussion of Institutional Practices.

Cureus 2021 Apr 7;13(4):e14345. Epub 2021 Apr 7.

Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.

Tracheostomies are often utilized in critically ill patients on prolonged mechanical ventilation, to enhance respiratory function and facilitate ventilator weaning. Many coronavirus disease 2019 (COVID-19) patients develop serious respiratory illness requiring ventilator management. In the early phase of this pandemic, the risk of disease spread lead to the development of conservative guidelines which advocated delaying tracheostomy at least two to three weeks from intubation and, preferably, with negative COVID-19 testing. Read More

View Article and Full-Text PDF

Tracheostomy ventilation in motor neurone disease: a snapshot of UK practice.

Amyotroph Lateral Scler Frontotemporal Degener 2021 May 8:1-7. Epub 2021 May 8.

Lane Fox Respiratory Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Motor neurone disease (MND) is characterized by rapidly progressive motor neurone degeneration which leads to muscle wasting. Mortality and morbidity are due to respiratory muscle failure which may be offset by ventilation. The aim of this observational study was to quantify the number and characteristics of patients living with MND choosing tracheostomy ventilation (TV) in the UK. Read More

View Article and Full-Text PDF

Prolonged Ventilatory Support for Patients Recovering From Guillain-Barré Syndrome.

Neurol Clin Pract 2021 Feb;11(1):18-24

Lane Fox Respiratory Service (MCFC, NH, MRBE, JES, RSH), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust; Lane Fox Clinical Respiratory Physiology Research Centre (MCFC, PBM, NH), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust; Department of Neurology (MRBE, JES), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust, London, United Kingdom; and Central Clinical School (MCFC), Faculty of Medicine and Health, University of Sydney, Australia.

Background: Recovery from Guillain-Barré syndrome (GBS) may be protracted, and patients may need prolonged ventilatory support. We present clinical data from a tertiary referral weaning center managing patients with GBS requiring prolonged ventilatory support.

Methods: A retrospective review of patients managed in a 34-bed specialist ventilator weaning facility in London, United Kingdom, between 2006 and 2017. Read More

View Article and Full-Text PDF
February 2021

Complex bronchial ruptures in blunt thoracic trauma: management and outcome.

Indian J Thorac Cardiovasc Surg 2021 May 15;37(3):311-315. Epub 2020 Sep 15.

General Surgery Department, Amiri Hospital, Kuwait City, Kuwait.

Complex bronchial ruptures are rare. Primary surgical repair is the preferred procedure. The aim of this retrospective case series was to study the clinical presentation of these complex bronchial injuries and their management and outcomes. Read More

View Article and Full-Text PDF

Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients - a prospective evaluation.

Neurol Res Pract 2021 May 10;3(1):26. Epub 2021 May 10.

Klinikum Osnabrück, Department of Neurology, Am Finkenhügel 1, 49076, Osnabrück, Germany.

Background: Removal of a tracheostomy tube in critically ill neurologic patients is a critical issue during intensive care treatment, particularly due to severe dysphagia and insufficient airway protection. The "Standardized Endoscopic Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients" (SESETD) is an objective measure of readiness for decannulation. This protocol includes the stepwise evaluation of secretion management, spontaneous swallowing, and laryngeal sensitivity during fiberoptic endoscopic evaluation of swallowing (FEES). Read More

View Article and Full-Text PDF

Outcomes Associated with Delayed Enteral Feeding after Cardiac Arrest Treated with Veno-Arterial Extracorporeal Membrane Oxygenation and Targeted Temperature Management.

Resuscitation 2021 May 6. Epub 2021 May 6.

Division of Cardiology, Department of Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States; Center for Resuscitation Medicine, University of Minnesota School of Medicine, Minneapolis, MN, United States. Electronic address:

Introduction: While early enteral nutrition is generally preferred in critically ill patients, the optimal timing of feeding among refractory cardiac arrest patients is unknown. We examined the association between timing of enteral nutrition and patient survival and safety outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA) who were treated with extracorporeal cardiopulmonary resuscitation (ECPR).

Methods: We performed a retrospective analysis of 142 consecutive patients presenting with OHCA due to ventricular fibrillation or ventricular tachycardia treated with ECPR and targeted temperature management (TTM). Read More

View Article and Full-Text PDF

Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury: Report of Two Cases.

Chest 2021 May;159(5):e299-e302

Hospital das Clínicas HC-FMUSP, São Paulo, SP, Brazil; Rede de Núcleos de Assistência e Pesquisa em Neuromodulação - NAPeN Network, São Paulo, SP, Brazil; Laboratory of Medical Investigations - LIM-54, São Paulo, SP, Brazil; São Paulo University, São Paulo, SP, Brazil.

High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). Read More

View Article and Full-Text PDF

Perioperative Management Of Children With Neuromuscular Disorders Based On A Common Protocol: A Prospective, National Study In Italy.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Department of Emergency Medicine, Anaesthesia and Intensive Care, University Hospital Agostino Gemelli IRCCS, Rome, Italy.

Background: Children with neuromuscular diseases (NMDs) often display respiratory muscle weakness which increases the risk of postoperative pulmonary complications (PPCs) after general anaesthesia. Non-invasive ventilation (NIV) associated with mechanical insufflation-exsufflation (MI-E) can reduce the incidence and severity of PPCs. The aim of this study was to report our experience with a shared peri-operative protocol that consists in using NIV combined with MI-E to improve the postoperative outcome of NMD children (IT-NEUMA-Ped). Read More

View Article and Full-Text PDF

Effects on mortality of early vs late administration of convalescent plasma in the treatment of Covid-19.

Transfus Apher Sci 2021 Apr 24:103148. Epub 2021 Apr 24.

Department of Anaesthesiology and Reanimation, Sakarya University Education and Research Hospital, Sakarya, Turkey.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first seen in the city of Wuhan, China, in December 2019 and then spread worldwide. On 24 March 2020, the U.S. Read More

View Article and Full-Text PDF

Discordant SARS-CoV-2 Detection in the Nasopharynx Versus Trachea for Patients With Tracheostomies.

Laryngoscope 2021 May 6. Epub 2021 May 6.

Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.

Objectives/hypothesis: Patients with tracheostomies have an anatomically altered connection between their upper and lower airways that could impact SARS-CoV-2 testing. Our goal was to evaluate for discordance in SARS-CoV-2 detection in hospitalized patients with COVID-19 and tracheostomies based on the site analyzed.

Study Design: Retrospective chart review METHODS: This single-institution study evaluated hospitalized patients with COVID-19 who had tracheostomies placed during their treatment. Read More

View Article and Full-Text PDF

Aerosol drug delivery to tracheotomized patients with COVID-19: Pragmatic suggestions for clinicians.

Can J Respir Ther 2021 30;57:49-52. Epub 2021 Apr 30.

Department of Respiratory Care, Texas State University, College of Health Professions, Round Rock, TX, USA.

Because of the wide and rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the number of hospitalized patients with coronavirus disease 2019 (COVID-19) has rapidly increased medically complex and resource-intensive treatment requirements in health care settings. Although tracheostomy is frequently needed for critically ill patients requiring extended mechanical ventilation, it has been described as an aerosol-generating procedure that puts health care professionals at an increased risk of viral transmission. In addition, the delivery of aerosolized medications to this patient population has become controversial because of concerns on the transmission of SARS-CoV-2 via droplets. Read More

View Article and Full-Text PDF

Beneficial Outcomes of Early Tracheostomy in Patients Requiring Prolonged Mechanical Ventilation.

Tanaffos 2020 Dec;19(4):350-355

Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Considering that tracheostomy is being done for huge amount of critically ill patients, the ideal time for this procedure is still controversial among different intensive care units (ICU).

Materials And Methods: 70 intubated patients were included in our study which was sorted into two subgroups: half of our patients received an early tracheostomy (ET) within 1-10 days post intubation and the rest received late tracheostomy (LT) within 11-21 days after getting intubated.

Results: 61. Read More

View Article and Full-Text PDF
December 2020

Tracheostomy on infants born in the periviable period: Outcomes at discharge from the neonatal intensive care unit (NICU).

Int J Pediatr Otorhinolaryngol 2021 Apr 27;146:110746. Epub 2021 Apr 27.

Department of Otorhinolaryngology H & N Surgery, University of Maryland School of Medicine and University of Maryland Children's Hospital, Baltimore, MD, USA.

Objectives: Advances in neonatal intensive care have allowed successful resuscitation of children born at the border of viability. However, there has been little change in the incidence of bronchopulmonary dysplasia (BPD) and anatomical upper airway obstruction which may require a tracheostomy in that group. The benefits of the procedure are accompanied by sequelae that impact outcomes. Read More

View Article and Full-Text PDF

Multidisciplinary management of a traumatic posterior meningeal artery pseudoaneurysm: A case report and review of the literature.

Int J Surg Case Rep 2021 Apr 29;82:105933. Epub 2021 Apr 29.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Background: Meningeal arterial injuries represent <1% of all blunt traumatic brain injuries (TBIs). Middle meningeal artery (MMA) lesions comprise the majority. However, there is little clinical data on posterior meningeal artery (PMA) injuries. Read More

View Article and Full-Text PDF

Laryngeal mask versus endotracheal tube for airway management in tracheal surgery: a case-control matching analysis and review of the current literature.

Interact Cardiovasc Thorac Surg 2021 May 6. Epub 2021 May 6.

Division of Thoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy.

Objectives: The endotracheal tube (ETT) and the laryngeal mask airway (LMA) are possible strategies for airway management during tracheal resection and reconstruction for tracheal and laryngotracheal stenosis. The goal of the study was to analyse and compare outcomes in the LMA and ETT groups.

Methods: Between 2003 and 2020, a total of 184 patients affected by postintubation, post-tracheostomy and idiopathic stenosis who had tracheal or laryngotracheal resections and reconstructions via a cervicotomy were retrospectively enrolled in this single-centre study. Read More

View Article and Full-Text PDF

Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units.

J Infect Dev Ctries 2021 Apr 30;15(4):584-589. Epub 2021 Apr 30.

Department of Microbiology, School of Medicine and PhD Program in Clinical Medicine and Public Health, University of Granada-ibs. Granada, España.

Introduction: Carbapenemase-producing Enterobacterales (CPE) have emerged as a substantial cause of morbi-mortality worldwide, with a prevalence of approximately 5% in areas with high endemicity. However, available data may not be representative of developing countries, such as Ecuador. In this study, the incidence of CPE in Ecuador and risk factors for infection/colonisation were evaluated. Read More

View Article and Full-Text PDF

Management of patients with bilateral recurrent laryngeal nerve paralysis following esophagectomy.

Thorac Cancer 2021 May 6. Epub 2021 May 6.

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Background: Recurrent laryngeal nerve paralysis (RLNP) is a common complication after esophagectomy which can cause severe pulmonary complications. However, bilateral RLNP has been rarely reported in esophagectomy patients. The objective of our study is to investigate the clinical significance of patients who had bilateral RLNP following esophagectomy. Read More

View Article and Full-Text PDF

Single-Dose del Nido Cardioplegia Compared With Standard Cardioplegia During Coronary Artery Bypass Grafting at a Veterans Affairs Hospital.

Tex Heart Inst J 2021 Jan;48(1)

Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas.

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85. Read More

View Article and Full-Text PDF
January 2021

Trends in inpatient palliative care use for primary brain malignancies.

Support Care Cancer 2021 May 4. Epub 2021 May 4.

George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW, DC Level, Washington, DC, 20037, USA.

Introduction: Primary brain malignancies (PBMs) pose significant morbidity and poor prognosis. Despite NCCN recommendations that palliative care should be integrated into general oncologic care plans, it has been historically underused in patients with PBM. We sought to examine trends and factors associated with inpatient palliative care use in patients with PBM. Read More

View Article and Full-Text PDF

Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for patients with laryngeal cicatricial stenosis: Safety and efficacy.

Head Neck 2021 May 4. Epub 2021 May 4.

Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China.

Background: We assessed the safety and efficacy of supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCL-CHEP) in patients with laryngeal cicatricial stenosis.

Methods: Sixteen patients receiving SCL-CHEP for severe laryngeal cicatricial stenosis between 2017 and 2018 were reviewed. Decannulation rate and tracheostomy closure time were used to evaluate efficacy. Read More

View Article and Full-Text PDF

"A Systematic Review on Guidelines and Recommendations for Tracheostomy During COVID-19 Pandemic".

Indian J Otolaryngol Head Neck Surg 2021 Apr 29:1-12. Epub 2021 Apr 29.

Department of ENT, Pandit Dindayal Upadhyay Medical College, Rajkot, Gujarat India.

World is under threat of COVID-19 pandemic, associated with many numbers of critically ill patients. To manage these intubated patients there are need of more ventilators but world is not prepared for this type of situation and there are lacunae of such arrangements in most of the countries. As we know patients cannot be intubated for long time and they should be given preference to alternative airway in the form of tracheostomy. Read More

View Article and Full-Text PDF