Spontaneous Breathing Trial
Spontaneous breathing trials (SBT) are used to identify patients who are likely to fail liberation from mechanical ventilation
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Spontaneous breathing trials (SBT) are used to identify patients who are likely to fail liberation from mechanical ventilation
Tracheostomy complications can be immediate, delayed or late
The presence of a tracheostomy tube can adversely effect swallowing: in patients who previously had no dysphagia; and further impair swallowing function in those who already have neurological or mechanical disorders of swallowing.
To perfrom a tracheostomy, knowledge of the following is required: surface anatomy, course of the trachea, structure of the tracheal rings, layers of dissection, components of the larynx and related structures
Tracheostomy is performed in critically ill adults requiring prolonged invasive ventilation as a strategy to: — reduce respiratory tract injury — improve patient comfort, and/or — to facilitate weaning
fenestrated tracheostomy tube. allows patient to breath normally with a tracheostomy in situ. patient can cough and speak through mouth. improves swallow function. acts a step prior to decannulation
Is this tracheostomy patient ready for decannulation? Hot Case
Ventilator management should be aimed at getting the patient off ventilator support as rapidly as possible. Weaning can be considered once the underlying process necessitating mechanical ventilation is resolving
Tracheostomy is an airway that is inserted subglottically through neck tissues directly into the trachea. Surgical Tracheostomy involves dissection and incision of trachea under direct vision.
Weaning from ventilation = Multi-factorial and list headings of causes -> clinical signs associated with list: Hot Case
Tracheostomy, advantages and disadvantages. Pro: reduced sedation requirement (greater comfort than oro-tracheal intubation). Con: requirement for a surgical procedure with inherent risk of complications
Approach to percutaneous dilatational tracheostomy (PDT) procedure