Tracheostomy in patients with long-term mechanical ventilation: a survey.

Salvatore Corrao, Santino Marchese, Nicolino Ambrosino, Raffaele Scala, Antonio Corrado

Risultato della ricerca: Article

36 Citazioni (Scopus)

Abstract

BACKGROUND:Tracheostomy is increasingly performed in intensive care units (ICU), with many patients transferred to respiratory ICU (RICU). Indications/timing for closing tracheostomy are discussed.AIM AND METHOD:We report results of a one-year survey evaluating: 1) clinical characteristics, types of tracheostomy, complications in patients admitted to Italian RICU in 2006; 2) clinical criteria and systems for performing decannulation, and outcome of patients undergoing tracheostomy (number decannulated; number non-decannulated/non-ventilated; number non-decannulated/ventilated; dead/lost patients).RESULTS:22/32 RICUs replied. There were 846 admissions of 719 patients (Mean age 64,3 (+/-14.2) years, 489 (68%) males). Causes of admission were: acute respiratory failure with underlying chronic co-morbidities 176 (24.4%); exacerbation of Chronic Obstructive Pulmonary Disease 222 (34.4%); neuromuscular diseases 200 (27.8%); surgical patients 77 (10.7%); thoracic dysmorphism 28 (3.8%); obstructive sleep apnea syndrome 16 (2.2%). Percutaneous tracheostomies were 65.9%. Major complications after tracheostomy were 2%. 427 tracheostomies were evaluated for decannulation: 96 (22.5%) were closed; 175 patients (41%) were discharged with home mechanical ventilation; 114 patients (26.5%) maintained the tracheostomy despite weaning from mechanical ventilation and 42 patients (10%) died or lost. The clinical criteria chosen for decannulation were: stability of respiratory conditions, effective cough, underlying diseases and ability to swallow. The systems for evaluating feasibility of decannulation were: closure of tracheostomy tube; laryngo-tracheoscopy; use of tracheal button and down-sizing.CONCLUSIONS:There were few major complications of tracheostomy. A substantial proportion of patients maintain the tracheostomy despite not requiring mechanical ventilation. There was no agreement on indications and systems for closing tracheostomy
Lingua originaleEnglish
pagine (da-a)749-753
Numero di pagine5
RivistaRespiratory Medicine
Volume104
Stato di pubblicazionePublished - 2010

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Tracheostomy
Artificial Respiration
Intensive Care Units
Surveys and Questionnaires
Respiratory Care Units
Neuromuscular Diseases
Patient Admission
Obstructive Sleep Apnea
Deglutition
Cough
Respiratory Insufficiency
Chronic Obstructive Pulmonary Disease
Thorax

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cita questo

Corrao, S., Marchese, S., Ambrosino, N., Scala, R., & Corrado, A. (2010). Tracheostomy in patients with long-term mechanical ventilation: a survey. Respiratory Medicine, 104, 749-753.

Tracheostomy in patients with long-term mechanical ventilation: a survey. / Corrao, Salvatore; Marchese, Santino; Ambrosino, Nicolino; Scala, Raffaele; Corrado, Antonio.

In: Respiratory Medicine, Vol. 104, 2010, pag. 749-753.

Risultato della ricerca: Article

Corrao, S, Marchese, S, Ambrosino, N, Scala, R & Corrado, A 2010, 'Tracheostomy in patients with long-term mechanical ventilation: a survey.', Respiratory Medicine, vol. 104, pagg. 749-753.
Corrao, Salvatore ; Marchese, Santino ; Ambrosino, Nicolino ; Scala, Raffaele ; Corrado, Antonio. / Tracheostomy in patients with long-term mechanical ventilation: a survey. In: Respiratory Medicine. 2010 ; Vol. 104. pagg. 749-753.
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abstract = "BACKGROUND:Tracheostomy is increasingly performed in intensive care units (ICU), with many patients transferred to respiratory ICU (RICU). Indications/timing for closing tracheostomy are discussed.AIM AND METHOD:We report results of a one-year survey evaluating: 1) clinical characteristics, types of tracheostomy, complications in patients admitted to Italian RICU in 2006; 2) clinical criteria and systems for performing decannulation, and outcome of patients undergoing tracheostomy (number decannulated; number non-decannulated/non-ventilated; number non-decannulated/ventilated; dead/lost patients).RESULTS:22/32 RICUs replied. There were 846 admissions of 719 patients (Mean age 64,3 (+/-14.2) years, 489 (68{\%}) males). Causes of admission were: acute respiratory failure with underlying chronic co-morbidities 176 (24.4{\%}); exacerbation of Chronic Obstructive Pulmonary Disease 222 (34.4{\%}); neuromuscular diseases 200 (27.8{\%}); surgical patients 77 (10.7{\%}); thoracic dysmorphism 28 (3.8{\%}); obstructive sleep apnea syndrome 16 (2.2{\%}). Percutaneous tracheostomies were 65.9{\%}. Major complications after tracheostomy were 2{\%}. 427 tracheostomies were evaluated for decannulation: 96 (22.5{\%}) were closed; 175 patients (41{\%}) were discharged with home mechanical ventilation; 114 patients (26.5{\%}) maintained the tracheostomy despite weaning from mechanical ventilation and 42 patients (10{\%}) died or lost. The clinical criteria chosen for decannulation were: stability of respiratory conditions, effective cough, underlying diseases and ability to swallow. The systems for evaluating feasibility of decannulation were: closure of tracheostomy tube; laryngo-tracheoscopy; use of tracheal button and down-sizing.CONCLUSIONS:There were few major complications of tracheostomy. A substantial proportion of patients maintain the tracheostomy despite not requiring mechanical ventilation. There was no agreement on indications and systems for closing tracheostomy",
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T1 - Tracheostomy in patients with long-term mechanical ventilation: a survey.

AU - Corrao, Salvatore

AU - Marchese, Santino

AU - Ambrosino, Nicolino

AU - Scala, Raffaele

AU - Corrado, Antonio

PY - 2010

Y1 - 2010

N2 - BACKGROUND:Tracheostomy is increasingly performed in intensive care units (ICU), with many patients transferred to respiratory ICU (RICU). Indications/timing for closing tracheostomy are discussed.AIM AND METHOD:We report results of a one-year survey evaluating: 1) clinical characteristics, types of tracheostomy, complications in patients admitted to Italian RICU in 2006; 2) clinical criteria and systems for performing decannulation, and outcome of patients undergoing tracheostomy (number decannulated; number non-decannulated/non-ventilated; number non-decannulated/ventilated; dead/lost patients).RESULTS:22/32 RICUs replied. There were 846 admissions of 719 patients (Mean age 64,3 (+/-14.2) years, 489 (68%) males). Causes of admission were: acute respiratory failure with underlying chronic co-morbidities 176 (24.4%); exacerbation of Chronic Obstructive Pulmonary Disease 222 (34.4%); neuromuscular diseases 200 (27.8%); surgical patients 77 (10.7%); thoracic dysmorphism 28 (3.8%); obstructive sleep apnea syndrome 16 (2.2%). Percutaneous tracheostomies were 65.9%. Major complications after tracheostomy were 2%. 427 tracheostomies were evaluated for decannulation: 96 (22.5%) were closed; 175 patients (41%) were discharged with home mechanical ventilation; 114 patients (26.5%) maintained the tracheostomy despite weaning from mechanical ventilation and 42 patients (10%) died or lost. The clinical criteria chosen for decannulation were: stability of respiratory conditions, effective cough, underlying diseases and ability to swallow. The systems for evaluating feasibility of decannulation were: closure of tracheostomy tube; laryngo-tracheoscopy; use of tracheal button and down-sizing.CONCLUSIONS:There were few major complications of tracheostomy. A substantial proportion of patients maintain the tracheostomy despite not requiring mechanical ventilation. There was no agreement on indications and systems for closing tracheostomy

AB - BACKGROUND:Tracheostomy is increasingly performed in intensive care units (ICU), with many patients transferred to respiratory ICU (RICU). Indications/timing for closing tracheostomy are discussed.AIM AND METHOD:We report results of a one-year survey evaluating: 1) clinical characteristics, types of tracheostomy, complications in patients admitted to Italian RICU in 2006; 2) clinical criteria and systems for performing decannulation, and outcome of patients undergoing tracheostomy (number decannulated; number non-decannulated/non-ventilated; number non-decannulated/ventilated; dead/lost patients).RESULTS:22/32 RICUs replied. There were 846 admissions of 719 patients (Mean age 64,3 (+/-14.2) years, 489 (68%) males). Causes of admission were: acute respiratory failure with underlying chronic co-morbidities 176 (24.4%); exacerbation of Chronic Obstructive Pulmonary Disease 222 (34.4%); neuromuscular diseases 200 (27.8%); surgical patients 77 (10.7%); thoracic dysmorphism 28 (3.8%); obstructive sleep apnea syndrome 16 (2.2%). Percutaneous tracheostomies were 65.9%. Major complications after tracheostomy were 2%. 427 tracheostomies were evaluated for decannulation: 96 (22.5%) were closed; 175 patients (41%) were discharged with home mechanical ventilation; 114 patients (26.5%) maintained the tracheostomy despite weaning from mechanical ventilation and 42 patients (10%) died or lost. The clinical criteria chosen for decannulation were: stability of respiratory conditions, effective cough, underlying diseases and ability to swallow. The systems for evaluating feasibility of decannulation were: closure of tracheostomy tube; laryngo-tracheoscopy; use of tracheal button and down-sizing.CONCLUSIONS:There were few major complications of tracheostomy. A substantial proportion of patients maintain the tracheostomy despite not requiring mechanical ventilation. There was no agreement on indications and systems for closing tracheostomy

UR - http://hdl.handle.net/10447/74673

M3 - Article

VL - 104

SP - 749

EP - 753

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

ER -