Abstract
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 long-term care hospital. The presence of a tracheostomy tube in the trachea can cause complications, including tracheal stenosis, bleeding, infection, aspiration pneumonia, and fistula formation from the trachea to either the esophagus or the innominate artery. Final removal of the tracheostomy tube is an important step in the recovery from chronic critical illness and can usually be done once the indication for the tube placement has resolved.
- mechanical ventilation
- tracheostomy
- decannulation
- speaking valve
- noninvasive ventilation
- long-term care hospital
Footnotes
- Correspondence: Heidi H O'Connor MD, Department of Pulmonary and Sleep Medicine, Rose Kalman Research Center, New England Sinai Hospital, 150 York Street, Stoughton MA 02072. E-mail: hoconnor{at}nesinai.org.
Alexander C White MD presented a version of this paper at the 25th New Horizons Symposium, “Airway Management: Current Practice and Future Directions,” at the 55th International Respiratory Congress of the American Association for Respiratory Care, held December 5–8, 2009, in San Antonio, Texas.
Dr O'Connor has disclosed no conflicts of interest. Dr White has disclosed a relationship with Breathe Technologies.
- Copyright © 2010 by Daedalus Enterprises Inc.
