Tracheostomy patients on the ward: multiple benefits from a multidisciplinary team?

Abstract

Patients requiring tracheostomies tend to have a longer length of stay due to their underlying disease. After a thorough literature search, Garrubba and colleagues found only three studies assessing the impact of multidisciplinary teams (MDTs) on tracheostomy patients on the ward. One consistent observation was the decreased time to decannulation after institution of MDT care when compared with historical controls. Although a large prospective randomized trial is desirable before MDT is recommended, many institutions may have already formed a team approach to provide coordinated care resulting in improved outcome and length of stay.

Heated air humidification versus cold air nebulization in newly tracheostomized patients

“…For example, >100 000 tracheostomies are performed annually in the United States. 21 Across Europe, 7%-16% of critical care admissions are managed with a tracheostomy, similar to data from the United States. 22 Around 25% of patients with upper aerodigestive tract malignancies, such as head and neck cancers, receive a tracheostomy.…”

“…A significant number of patients receive a tracheotomy for any reason. For example, >100 000 tracheostomies are performed annually in the United States . Across Europe, 7%‐16% of critical care admissions are managed with a tracheostomy, similar to data from the United States .…”

Tracheostomy: Epidemiology, Indications, Timing, Technique, and OutcomesDiscussion

“…19 The average number of tracheostomies performed annually in the United States now is Ͼ 100,000. 20 In the state of North Carolina between 1993 and 2002, the incidence of tracheostomy for prolonged mechanical ventilation increased in all age groups from 8.3 to 24.2/100,000, most significantly among patients Ͻ 55 y old. This was associated with a significant decrease in mortality (39% vs 25%), median ventilator days (12 vs 10), and median stay (47 vs 33 d).…”

How design characteristics of tracheostomy tubes affect the cannula and tracheal flows

“…Tracheostomy is a surgical procedure that involves an incision into the trachea and placement of a prosthetic breathing device . Approximately 100 thousand tracheostomy surgeries are performed every year in the United States . The average length of stay in the hospital for ventilator‐dependent patients with a tracheotomy is 28 days .…”

“…1 Approximately 100 thousand tracheostomy surgeries are performed every year in the United States. 2 The average length of stay in the hospital for ventilator-dependent patients with a tracheotomy is 28 days. 3 Complications after tracheostomy include bleeding, infection, pneumothorax, 4 airway stenosis resulting from granulation tissue, tracheomalacia, and airway obstruction.…”