TY - JOUR T1 - Editor’s Commentary JF - Respiratory Care SP - i LP - 1 VL - 68 IS - 2 A2 - , Y1 - 2023/02/01 UR - http://rc.rcjournal.com/content/68/2/i.abstract N2 - This month’s Editor’s Choice by Villarroel and colleagues details factors associated with accidental decannulation in children with a tracheostomy. Over a 5-year time frame they performed a case-control study of tracheostomy subjects with and without an accidental decannulation event. The majority of subjects (84%) were receiving mechanical ventilation and the primary cause of decannulation was self-decannulation. Risks were highest in children who reached midline in the sitting position and those with smaller tube sizes (<4.0 mm ID). Lower staff to patient ratios were also associated with more frequent decannulation. Awad and Berlinski provide commentary, highlighting the importance of devices to secure tubes, supports for ventilator circuits, and staff coverage. They also note that mortality in this population following accidental decannulation is low, owing to patient tolerance and effective tube replacement.Coppadoro et al describe a recirculation system to reduce oxygen use during helmet or mask CPAP with a Venturi-based, constant flow CPAP generator. This bench study directed exhaled gas through a CO2 absorber and back to the entrainment port of the CPAP generator, allowing a reduction in the set FIO2. They report an 80% reduction in oxygen use over 10 hours using a single soda lime cannister. The system also nearly … ER -