There are times when a tracheostomy tube slips out of the trachea. A displaced tracheostomy tube can occur in any patient but is frequently seen in the patient with a full neck. In the overweight patient or patient with a full neck, the tracheostomy tube must pass through a greater amount of soft tissue. Because of this, a smaller portion of the tube is actually within the lumen of the trachea. When the patient coughs excessively or moves the head, the tube can easily slip out of the trachea and into the interstitial tissues of the neck. If the patient has complete obstruction of the upper airway, a displaced tracheostomy tube will result in immediate respiratory distress and can lead to respiratory arrest. If the patient has an intact or at least a partially open upper airway, the displaced tube may not cause an immediate problem. Therefore, displacement of the tracheostomy tube may not be obvious in the patient with a partial airway.
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Int J Pediatr Otorhinolaryngol
January 2025
Purpose: Speech-language Therapists (SLTs) are specialists in communication, feeding and swallowing as core members of the paediatric tracheostomy multidisciplinary team (MDT). Inconsistent tracheostomy care leads to staff and family frustration and delayed intervention. Little is known about international SLT tracheostomy practices.
View Article and Find Full Text PDFIndian J Crit Care Med
November 2024
Department of Critical Care Medicine, Kasturba Medical College; Manipal Academy of Higher Education, Manipal, Karnataka, India.
Aim And Background: Tracheostomy is a commonly conducted surgical intervention in intensive care settings, and many complications result from tracheostomy. The use of an evidence-based methodology for tracheostomy care can effectively mitigate the occurrence of complications. This study aimed to assess tracheostomy complications among patients, determine nurses' knowledge and practice of tracheostomy care, and evaluate the effectiveness of a tracheostomy care protocol (TCP) in terms of improving knowledge and practice of tracheostomy care and reducing complications among patients.
View Article and Find Full Text PDFChest
January 2025
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany. Electronic address:
Background: There is limited knowledge about long-term mortality, care pathways and health-related quality of life (HrQoL) among intensive care unit (ICU) patients receiving prolonged mechanical ventilation (PMV).
Research Question: What are the long-term mortality, care pathways, and HrQoL of patients receiving invasive PMV, stratified by weaning success?
Study Design: and methods: We conducted a secondary analysis of patients from the cluster-randomised controlled Enhanced Recovery after Intensive Care trial who were treated in two ICU clusters and received invasive PMV (≥21 days via endotracheal tube/tracheostomy or ≥four days via tracheostomy). Data on weaning success, mortality, care place transitions, readmissions, and HrQoL were collected for six months after ICU discharge.
Clin Transplant
February 2025
Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Background: Invasive Candida infections (ICI) are the most common invasive fungal infections in solid organ transplant recipients. There are limited contemporary data on the risk factors for infection in heart transplant (HT) recipients especially since the expansion of temporary mechanical circulatory support (MCS) use.
Methods: This was a case-control study conducted at a tertiary care academic hospital of HT recipients from January 2022 to January 2024.
J Cardiothorac Surg
January 2025
Institute of Cardiovascular and Thoracic Surgery, Madras Medical College, Chennai, India.
Background: Penetrating neck injuries are rare and require urgent surgical intervention to prevent life-threatening complications. This report highlights a unique case involving complex surgical repair of tracheal, esophageal, and vascular injuries following a homicidal assault, emphasizing the challenges and techniques used in managing such severe trauma.
Case Presentation: A 45-year-old female presented with a severe penetrating neck injury after an alleged homicidal assault with a knife.
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