Expiratory airflow obstruction due to tracheostomy tube: A spirometric study in 50 patients.
decannulation
expiratory flow limitation
head neck cancer
tracheostomy
upper airway obstruction
weaning
Journal
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
ISSN: 1749-4486
Titre abrégé: Clin Otolaryngol
Pays: England
ID NLM: 101247023
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
22
04
2018
revised:
02
04
2020
accepted:
26
04
2020
pubmed:
1
5
2020
medline:
9
10
2021
entrez:
1
5
2020
Statut:
ppublish
Résumé
Tracheostomy is commonly used in intensive care units and in head and neck departments. Airway obstruction due to occluded cuffless tracheostomy tubes themselves remains unknown, although capping trials are commonly used before decannulation. The aim of this study was to evaluate the extent to which airway obstruction can be caused by occluded cuffless tubes in patients who underwent head and neck surgery. Prospective Research Outcome. University teaching hospital. Fifty patients requiring transient tracheostomy after head and neck surgery. A flow-volume loop (FVL) through the mouth using a portable spirometer, with the occluded fenestrated cuffless tube, was measured before and immediately after decannulation, by obstructing the orifice of tracheostomy tube. The measurement of FVL recorded the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV A statistically significant difference between all spirometric parameters was found. Mean PEF and PIF, respectively, increased from 2.8 to 4.5 L/s (P < .0001) and 2.3 to 2.7 L/s (P < .01) before and after decannulation, with a strong positive correlation (r = 0.7; P < .05). A mean expiratory (34%) and inspiratory (9%) airflow reduction was observed due to cannula. Occluded cuffless tracheostomy tubes cause a dramatic airflow obstruction, mainly in the expiratory phase of FVL. This should be taken into account during capping trials.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
703-709Informations de copyright
© 2020 John Wiley & Sons Ltd.
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