Episode 66: Trach and Peg
Are tracheostomy really inevitable consequences of acute respiratory failure?
Are they always from “lung failure”… or could it often be our failure to preserve function of the rest of the body?
What happens to patients after a tracheostomy? Where do they go? How does it impact their mortality and re-hospitalization rates? What happens to their tracheas after being cannulated? What is their quality of life like?
What is going on with our “trach and peg” culture?
References:
Bailey, P., Thomsen, G., Spuhler, V., Blair, R., Jewkes, J., Bezdjian, L., Veale, K., Rodriguez, L., & Hopkins, R. (2007). Early activity is feasible and safe in respiratory failure patients. Critical Care Medicine. http://www0.sun.ac.za/Physiotherapy_ICU_algorithm/Documentation/Rehabilitation/References/Baily_07.pdf
El-Anwar, M., Nofal, A., Shawadfy, M., Maaty, A., & Khazbak, A. (2017). Tracheostomy in the intensive care unit: a university hospital in a developing country study. International Archives of Otorhinologarngology, 21(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5205538/
Hickmann, C., Montecinos-Munoz, N., Castanares-Zapatero, Arriagada-Garrido, R., Jeria-Blanco, U., Gizzatullin, T., Roeseler, J., Dugernier, J., Wittebole, X., & Laterre, P. (2021) Acute effects of sitting out of bed and exercise on lung aeration and oxygenation in critically ill subjects. Respiratory Care, 66(2). https://pubmed.ncbi.nlm.nih.gov/32994357/
Keough, E., Lopez-Rodriaguez, L., Carriedo, D., Goncalves, G., Barreiro, E., & Lorente, J. (2019). Ventilator-induced diaphragm dysfunction: translation mechanisms lead to therapeutical alternatives in the critically ill. Intensive Care Medicine, 7(48). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658639/Mehta, A., Walkey, A., Everett, D., & Douglas, I. (2019). One-year outcomes following acute respiratory failure. Critical Care Medicine, 47(11). https://pubmed.ncbi.nlm.nih.gov/31397716/
Saccheri, C., Morawiec, E., Delemazure, J., Mayaux, J., Dube, B., Similowski, T., Demoule, A., & Dres, M. (2020). ICU-acquired weakness, diahpragm dysfunction, and long-term outcomes of critically ill patients. Annals of Intensive Care, 10(1). https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-
Spataro E, Durakovic N, Kallogjeri D, Nussenbaum B. Complications and 30-day hospital readmission rates of patients undergoing tracheostomy: A prospective analysis. Laryngoscope. 2017;127(12):2746–53. https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.26668
