BACKGROUND Tracheostomy is one of the most common surgical procedures performed in critical care patient management; more specifically, ventilation through tracheal cannula allows removal of the endotracheal tube (ETT). Available literature about tracheostomy care and decannulation is mainly represented by expert opinions and no certain knowledge arises from it. METHODS In lack of statistical...

INTRODUCTION When patients are transferred from intensive care units (ICUs) to general wards with a tracheostomy in situ, there is a risk of suboptimal care and increased morbidity. The aim of this study was to elucidate the management of patients with a tracheostomy in situ at discharge from the ICU to the ward. MATERIAL AND METHODS We performed an electronic questionnaire survey among heads...

OBJECTIVE To determine the relationship between tracheostomy tube in place after intensive-care-unit (ICU) discharge and hospital mortality. METHODS We conducted a prospective observational cohort study in a medical-surgical ICU in a tertiary-care hospital that does not have a step-down unit. We recorded clinical and epidemiologic variables, indication and timing of tracheostomy, time to deca...

Tracheostomy tubes are placed for a variety of reasons, including failure to wean from mechanical ventilation, inability to protect the airway due to impaired mental status, inability to manage excessive secretions, and upper-airway obstruction. A tracheostomy tube is required in approximately 10% of patients receiving mechanical ventilation and allows the patient to move to a step-down unit or...

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, Onta...

BACKGROUND For percutaneously tracheostomized patients with prolonged weaning and persisting respiratory failure, the adequate time point for safe decannulation and switch to noninvasive ventilation is an important clinical issue. OBJECTIVES We aimed to evaluate the usefulness of a tracheostomy retainer (TR) and the predictors of successful decannulation. METHODS We studied 166 of 384 patie...

PURPOSE This study was designed to evaluate the effect of tracheostomy site suturing after decannulation on swallowing rehabilitation, the incidence of postoperative complications, the length of hospital stay, and overall cost saving in patients undergoing major head and neck cancer resections. DESIGN Prospective, randomized, blinded, controlled clinical trial. METHODS Seventy-five patients...

BACKGROUND Endoprosthesis are being used in the everyday clinical practice either as a permanent solution or transient. They can be used in both benign and malignant situations. CASE PRESENTATION We report a case in which a temporary Montgomery cannula is used in conjunction with therapeutic bronchoscopy to manage a patient with failed tracheostomy decannulation secondary to a distal complex ...

OBJECTIVE Variables predicting optimal timing for tracheostomy decannulation remain unknown. We aimed to determine whether classifying patients into two groups according to their indications for tracheostomy could identify variables associated with time to decannulation. DESIGN A prospective, observational cohort study was carried out. LOCATION Two medical-surgical ICUs. PATIENTS We inclu...

OBJECTIVE To analyze the impact of decannulation before intensive care unit discharge on ward survival in nonexperimental conditions. DESIGN Prospective, observational survey. SETTING Thirty-one intensive care units throughout Spain. PATIENTS All patients admitted from March 1, 2008 to May 31, 2008. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS At intensive care unit discharge, we...