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Abstract
BACKGROUND: Tracheostomies provide many advantages for the care of patients who are critically ill but may also result in complications, including tracheostomy-related pressure injuries. Research efforts into the prevention of these pressure injuries has resulted in specialized clinical care teams and pathways. These solutions are expensive and labor intensive, and fail to target the root cause of these injuries; namely, pressure at the device-skin interface. Here we measure that pressure directly and introduce a medical device, the tracheostomy support system, to reduce it.
METHODS: This was a cross-sectional study of 21 subjects in the ICU, each with a tracheostomy tube connected to a ventilator. A force-sensing resistor was used to measure baseline pressures at the device-skin interface along the inferior flange. This pressure was then measured again with the use of the tracheostomy support system in the inactive and active states. Resultant pressures and demographics were compared.
RESULTS: Fifteen male and 6 female subjects, with an average age of 47 ± 14 (mean ± SD) years, were included in this study. Average pressures at the tracheostomy-skin interface at baseline in these 21 ICU subjects were 273 ± 115 (mean ± SD) mm Hg. Average pressures were reduced by 59% (median 62%, maximum 98%) with the active tracheostomy support system to 115 ± 83 mm Hg (P < .001). All the subjects tolerated the tracheostomy support system without issue.
CONCLUSIONS: Despite best clinical practice, pressure at the tracheostomy-skin interface can remain quite high. Here we provide measures of this pressure directly and show that a tracheostomy support system can be effective at minimizing that pressure.
- tracheostomy
- tracheotomy
- pressure ulcer
- skin diseases
- skin ulcer
- respiratory insufficiency
- artificial respiration
- critical care
Footnotes
- Correspondence: Andrew M Vahabzadeh-Hagh MD, Department of Otolaryngology/Head and Neck Surgery, University of California, 8899 University Center Lane, Suite 240, San Diego, CA 92122. E-mail: avahabz{at}health.ucsd.edu
The study was performed at the Jacobs Medical Center at the University of California San Diego Health, La Jolla, California.
Dr Vahabzadeh-Hagh is the inventor of the tracheostomy support system, the device used in this study, which is investigational and not commercially available. This technology is licensed to Larynnovation, which Dr Vahabzadeh-Hagh founded. Larynnovation was not part of the institutional review board study, did not have access to the results, nor did it provide any funding for this non-funded human study. The terms of this arrangement have been reviewed and approved by the University of California, San Diego, in accordance with its conflicts of interest policies. The other authors have disclosed no conflicts of interest.
- Copyright © 2024 by Daedalus Enterprises
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