Search results for "Tracheotomy"
showing 10 items of 13 documents
Tracheal Ceramic Rings for Tracheomalacia: A Review After 17 Years
2007
Background: Despite different support techniques, the surgical management of tracheomalacia is still a challenging problem. Satisfactory results after internal stenting are above 80%, whereas, when performing external stenting using biocompatible ceramic rings, results are reported at over 90%. Objective: The purpose of this study was to examine the efficiency of surgical treatment in patients with segmentary tracheomalacia using external ceramic ring grafts. Methods: In this retrospective study, we collected data from 12 patients who underwent surgery during the last 17 years for symptomatic segmentary tracheomalacia by use of biocompatible aluminum-oxide ceramic rings. All except one pati…
Outcome and attitudes toward home tracheostomy ventilation of consecutive patients: a 10-year experience.
2008
Summary Objectives To describe survival, predictors of long-term outcome and attitudes in patients treated at home by tracheostomy-intermittent positive-pressure ventilation (TIPPV) for respiratory failure during a 10-year period (1995–2004). Methods Seventy-seven consecutive patients were treated by TIPPV at home. Patients were divided into three groups: neuromuscular, pulmonary, and non-pulmonary patients. Effects of TIPPV on survival, factors influencing outcome after TIPPV, and attitudes of patients and caregivers regarding mechanical ventilation were studied. Results Forty-one patients (53%) were neuromuscular, 19 (25%) were affected by pulmonary diseases, and 17 (22%) by non-pulmonary…
Radiosurgery in the treatment of laryngeal abductor paralysis
2003
Abstract Abductor true vocal cord paralysis is a complex condition that requires the surgeon to perform an emergency tracheotomy to eliminate the symptom of dyspnea. Throughout the past 20 years, corrective surgery has reverted to techniques using external or endoscopic techniques. For 5 years now, we have used high frequency radiosurgery by Ellman to treat various ENT conditions in our clinic. The experience we have gained has encouraged us to use this method in endoscopic surgery as well, in the treatment of laryngeal abductor paralysis under suspension microlaryngoscopy. Twelve patients were examined between 1999 and 2002. Diagnosis was performed through flexible fiberoptic videolaryngos…
Pulmonary effects of expiratory-assisted small-lumen ventilation during upper airway obstruction in pigs
2015
Summary Novel devices for small-lumen ventilation may enable effective inspiration and expiratory ventilation assistance despite airway obstruction. In this study, we investigated a porcine model of complete upper airway obstruction. After ethical approval, we randomly assigned 13 anaesthetised pigs either to small-lumen ventilation following airway obstruction (n = 8) for 30 min, or to volume-controlled ventilation (sham setting, n = 5). Small-lumen ventilation enabled adequate gas exchange over 30 min. One animal died as a result of a tension pneumothorax in this setting. Redistribution of ventilation from dorsal to central compartments and significant impairment of the distribution of ve…
Medical complications in a telemedicine home care programme for paediatric ventilated patients.
2019
Introduction Advances in paediatric medicine have increased survival rates for patients with severe chronic illnesses, of which the most complex are ventilator-dependent children (VDCs). Although home care improves their quality of life, morbidity and mortality rates are high. Our aim was to study the medical complications (events) that occur at home and assess the usefulness of telemedicine in their detection and treatment. Methods A prospective clinical study (2007–2017) was performed for tracheotomised VDCs. We used a high-density data telemedicine monitoring system from our Paediatric Intensive Care Unit and analysed events during the first two years of home care to study how different …
Early extubation followed by immediate noninvasive ventilation vs. standard extubation in hypoxemic patients: a randomized clinical trial
2018
Purpose: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. Methods: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation. Co-primary end points were duration of i-MV and ICU LOS. Secondary end points were treatment failure, severe events (hemorrhagic, septic, cardiac, renal or neurologic …
Noninvasive respiratory muscle aids during PEG placement in ALS patients with severe ventilatory impairment.
2010
Abstract Although no clear recommendations are given about when percutaneous endoscopic gastrostomy (PEG) should be placed in amyotrophic lateral sclerosis (ALS) patients, some experts underline the risk of respiratory complications when patients had severe ventilatory muscle impairment (SVMI). Aim To evaluate the efficacy of noninvasive ventilation (NIV) and mechanically assisted cough (MAC) to avoid respiratory complications related to PEG placement in ALS patients with SVMI. Material and methods Prospective study including ALS patients who had chosen to have PEG placement timed by swallowing dysfunction with the aid of NIV and MAC if needed. PEG was carried out under volume-cycled NIV th…
Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease
2021
OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need fo…
Timing, Complications, and Safety of Tracheotomy in Critically Ill Patients With COVID-19
2021
Importance: The current coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented needs for invasive ventilation, with 10% to 15% of intubated patients subsequently requiring tracheotomy. Objective: To assess the complications, safety, and timing of tracheotomy performed for critically ill patients with COVID-19. Design, Setting, and Participants: This prospective cohort study assessed consecutive patients admitted to the intensive care unit (ICU) who had COVID-19 that required tracheotomy. Patients were recruited from March 16 to April 10, 2020, at a tertiary referral center. Exposures: A surgical tracheotomy was performed for all patients following recommended criteria for use…
Laryngeal involvement in relapsing polychondritis: Case report and review of literature
2018
Relapsing polychondritis is a rare multisystem autoimmune disease of unknown origin characterised by recurrent episodes of inflammation and progressive destruction of the cartilaginous structures and connective tissue of the whole body. The diagnosis of relapsing polychondritis is difficult. We present a review of the literature and describe a case of 49-year old woman. Her symptoms began in June 2004 with sore throat, dysphonia, pain in the thoracic wall and some joints, a slightly raised temperature and cough. The objective picture was immediately apparent after carrying out a high definition neck-thorax computed tomography and a laryngoscopy with fiber optics, which showed considerable l…