Tracheostomy tube malposition in patients admitted to a respiratory acute care unit following prolonged ventilation.

Chest
Ulrich SchmidtHenry Thomas Stelfox

Abstract

Tracheostomy tube malposition is a barrier to weaning from mechanical ventilation. We determined the incidence of tracheostomy tube malposition, identified the associated risk factors, and examined the effect of malposition on clinical outcomes. We performed a retrospective study on 403 consecutive patients with a tracheostomy who had been admitted to an acute care unit specializing in weaning from mechanical ventilation between July 1, 2002, and December 31, 2005. Bronchoscopy reports were reviewed for evidence of tracheostomy tube malposition (ie, > 50% occlusion of lumen by tissue). The main outcome parameters were the incidence of tracheostomy tube malposition; demographic, clinical, and tracheostomy-related factors associated with malposition; clinical response to correct the malposition; the duration of mechanical ventilation; the length of hospital stay; and mortality. Malpositioned tracheostomy tubes were identified in 40 of 403 patients (10%). The subspecialty of the surgical service physicians who performed the tracheostomy was most strongly associated with malposition. Thoracic and general surgeons were equally likely to have their patients associated with a malpositioned tracheostomy tube, while other subspecialty s...Continue Reading

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Citations

Mar 10, 2010·Intensive Care Medicine·P CerianaS Nava
Dec 15, 2010·Critical Care : the Official Journal of the Critical Care Forum·John McCracken, David Leasa
Oct 7, 2010·Expert Review of Respiratory Medicine·Nicolino Ambrosino, Luciano Gabbrielli
Mar 15, 2011·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Itzhak Brook
Jul 27, 2018·Journal of Bronchology & Interventional Pulmonology·Fernando PlanellsDiego Noval
Mar 28, 2012·Anesthesia and Analgesia·Itzhak Brook
Nov 1, 2012·Australasian Journal of Ultrasound in Medicine·Máté Rudas
Nov 1, 2015·Journal of the Intensive Care Society·Joshua MoorhouseDavid Owens
Jun 27, 2021·Journal of Digital Imaging·Robert D E HendersonPaul Babyn
Dec 7, 2021·Anaesthesia and Intensive Care·Prakkash P AnanthanBradley A Wibrow

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