Chest Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bach, J.
Right arrow Articles by Alba, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bach, J.
Right arrow Articles by Alba, A.

Chest, Vol 97, 679-683, Copyright © 1990 by American College of Chest Physicians

ARTICLES

Tracheostomy ventilation. A study of efficacy with deflated cuffs and cuffless tubes

JR Bach and AS Alba
Department of Physical Medicine and Rehabilitation, New Jersey Medical School, University of Medicine and Dentistry of New Jersey.

The purpose of this study was to evaluate the effectiveness of long- term tracheostomy intermittent positive pressure ventilation (TIPPV) with deflated cuffs or cuffless tracheostomy tubes for patients with neuromuscular ventilatory failure. One hundred four unweanable ventilator-dependent patients with neuromuscular ventilatory insufficiency were referred for pulmonary rehabilitation. Ninety-one of the 104 patients converted from TIPPV with an inflated cuff to either a deflated cuff (28 patients) or no cuff (63 patients). Arterial blood gas (ABG) and routine daytime monitoring of end-tidal PCo2 were performed on all patients during this transition. In addition, periodic daytime and continuous overnight oximetry were performed on 21 of these patients receiving TIPPV with deflated cuffs or cuffless tubes. Thirteen of the 21 patients also had continuous overnight end-tidal PCo2 monitoring. Despite a mean vital capacity of 17 +/- 12.3 percent and the fact that 16 of the 21 patients could tolerate only 60 minutes or less of autonomous respiration (free time), ABG, daytime SaO2 and end-tidal PCo2 were within normal limits for all 21 patients and mean overnight SaO2 was 94 percent or greater for all except one patient who used a cuffless tracheostomy tube. Six patients experienced very transient desaturations below 90 percent but no one had a maximum end- tidal PCo2 greater than 47 mm Hg. Patients with adequate pulmonary compliance and sufficient oropharyngeal muscle strength for functional swallowing and articulation are candidates for conversion to TIPPV with deflated cuffs or cuffless tracheostomy tubes despite little or no autonomous respiration.


This article has been cited by other articles:


Home page
 Eur Respir JHome page
H. Prigent, D. Orlikowski, M. B. Blumen, K. Leroux, L. Legrand, M. Lejaille, L. Falaize, M. Ruquet, J-C. Raphael, and F. Lofaso
Characteristics of tracheostomy phonation valves.
Eur. Respir. J., May 1, 2006; 27(5): 992 - 996.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. Servera and J. Sancho
Appropriate Management of Respiratory Problems Is of Utmost Importance in the Treatment of Patients With Amyotrophic Lateral Sclerosis
Chest, June 1, 2005; 127(6): 1879 - 1882.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
Respiratory Care of the Patient with Duchenne Muscular Dystrophy: ATS Consensus Statement
Am. J. Respir. Crit. Care Med., August 15, 2004; 170(4): 456 - 465.
[Full Text] [PDF]

Home page
 ChestHome page
H. Nomori
Tracheostomy Tube Enabling Speech During Mechanical Ventilation
Chest, March 1, 2004; 125(3): 1046 - 1051.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. D. Hoit, R. B. Banzett, H. L. Lohmeier, T. J. Hixon, and R. Brown
Clinical Ventilator Adjustments That Improve Speech
Chest, October 1, 2003; 124(4): 1512 - 1521.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Baydur and G. Kanel
Tracheobronchomalacia and Tracheal Hemorrhage in Patients With Duchenne Muscular Dystrophy Receiving Long-term Ventilation With Uncuffed Tracheostomies
Chest, April 1, 2003; 123(4): 1307 - 1311.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. D. Hoit and R. B. Banzett
Je Peux Parler!
Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 101 - 102.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
H. Prigent, C. Samuel, B. Louis, M.-F. Abinun, F. Zerah-Lancner, M. Lejaille, J.-C. Raphael, and F. Lofaso
Comparative Effects of Two Ventilatory Modes on Speech in Tracheostomized Patients with Neuromuscular Disease
Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 114 - 119.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. Lofaso and M.A. Quera-Salva
Polysomnography for the management of progressive neuromuscular disorders
Eur. Respir. J., June 1, 2002; 19(6): 989 - 990.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
Y. Skrobik and C. Gregoretti
Translaryngeal open ventilation to treat acute respiratory failure in acute exacerbation of chronic obstructive pulmonary disease. A preliminary report : [La ventilation ouverte, translaryngee, pour traiter l'insuffisance respiratoire aigue d'une maladie pulmonaire obstructive chronique : un compte rendu preliminaire]
Can J Anesth, December 1, 2001; 48(11): 1161 - 1164.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1990 by the American College of Chest Physicians.