An Overview of Tracheostomy Tubes and Mechanical Ventilation Management for the Speech-Language Pathologist

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2021_persp-20-00105 ◽

2021 ◽

pp. 1-12

Author(s):

George Barnes ◽

Nancy Toms

Keyword(s):

Mechanical Ventilation ◽

Complex Disease ◽

Feeding Tube ◽

Ventilator Weaning ◽

Care Plans ◽

Speech Language Pathologist ◽

Integral Role ◽

Solid Foundation ◽

Tracheostomy Tubes ◽

Ventilation Management

Purpose The speech-language pathologist (SLP) plays an integral role when working with patients who have tracheostomy tubes and are on mechanical ventilation. The patients and the clinical team depend on our expertise to make critical decisions on speaking valve use, introduction of food by mouth (per os), weaning off of the ventilator, weaning from the feeding tube, and tracheostomy tube decannulation. Conclusions While not expected to be experts on the cardiopulmonary function of patients, SLPs must have a solid foundation of knowledge when it comes to patients with highly complex disease processes and care plans. This clinical focus article is meant to serve as an overview for the SLP working with tracheostomy tubes and ventilators and for those SLPs interested in entering this area of practice.

Download Full-text

Mechanical ventilation management in patients diagnosed with Covid-19 who underwent pediatric openheart surgery

Journal of Clinical Medicine of Kazakhstan ◽

10.23950/jcmk/11242 ◽

2021 ◽

Vol 18 (5) ◽

pp. 82-87

Author(s):

Ergi̇n Arslanoğlu ◽

Kenan Abdurrahman Kara ◽

Fatih Yigit ◽

Ömer Faruk Şavluk ◽

Nihat Çine ◽

...

Keyword(s):

Mechanical Ventilation ◽

Ventilation Management

Download Full-text

Respiratory and Mechanical Ventilation Management: Avoidance of Complications

Passport to Successful ICU Discharge ◽

10.1007/978-3-030-38916-1_2 ◽

2020 ◽

pp. 15-27

Author(s):

Joan-Daniel Martí ◽

Roberto Martinez-Alejos

Keyword(s):

Mechanical Ventilation ◽

Ventilation Management

Download Full-text

Endotracheal and Enteric Tubes

Chest Imaging ◽

10.1093/med/9780199858064.003.0007 ◽

2019 ◽

pp. 35-39

Author(s):

Tyler H. Ternes

Keyword(s):

Mechanical Ventilation ◽

Gas Exchange ◽

Endotracheal Tube ◽

Medical Devices ◽

Esophageal Intubation ◽

Ideal Position ◽

Tracheostomy Tubes ◽

Tube Malposition ◽

The Ideal

The Endotracheal and Enteric Tubes chapter addresses these frequently used medical devices. An endotracheal tube (ETT) is a catheter placed into the airway for mechanical ventilation. It serves to protect the airway and provide adequate gas exchange. The ideal position of the endotracheal tube tip is approximately 5 cm above the carina. Complications of ETT placement include inadequate ventilation if placed too high or too low, esophageal intubation and tracheal injury. Tracheostomy tubes are used in patients who require long-term intubation. Enteric tubes are thin flexible hollow catheters that course into the stomach and beyond. They may be placed via nasal (nasogastic) or oral (orogastric) approach. When used for suctioning, the ideal position of the tube tip is within the stomach. When used for administration of drugs or nutrition, the tube tip is ideally advanced beyond the pylorus. Enteric tube malposition may be due to coiling within the esophagus or inadvertent malposition within the airway. Malpositioning could result in aspiration, lung injury, and pneumothorax.

Download Full-text

Evaluation of Delivery of Enteral Nutrition in Critically Ill Patients Receiving Mechanical Ventilation

American Journal of Critical Care ◽

10.4037/ajcc2008.17.1.53 ◽

2008 ◽

Vol 17 (1) ◽

pp. 53-61 ◽

Cited By ~ 71

Author(s):

Debra O’Meara ◽

Eduardo Mireles-Cabodevila ◽

Fran Frame ◽

A. Christine Hummell ◽

Jeffrey Hammel ◽

...

Keyword(s):

Mechanical Ventilation ◽

Enteral Nutrition ◽

Critically Ill ◽

Critically Ill Patients ◽

Feeding Tube ◽

Feeding Tubes ◽

Academic Center ◽

Specific Step ◽

Feeding Process ◽

Medical Intensive Care

Background Published reports consistently describe incomplete delivery of prescribed enteral nutrition. Which specific step in the process delays or interferes with the administration of a full dose of nutrients is unclear. Objectives To assess factors associated with interruptions in enteral nutrition in critically ill patients receiving mechanical ventilation. Methods An observational prospective study of 59 consecutive patients who required mechanical ventilation and were receiving enteral nutrition was done in an 18-bed medical intensive care unit of an academic center. Data were collected prospectively on standardized forms. Steps involved in the feeding process from admission to discharge were recorded, each step was timed, and delivery of nutrition was quantified. Results Patients received approximately 50% (mean, 1106.3; SD, 885.9 Cal) of the prescribed caloric needs. Enteral nutrition was interrupted 27.3% of the available time. A mean of 1.13 interruptions occurred per patient per day; enteral nutrition was interrupted a mean of 6 (SD, 0.9) hours per patient each day. Prolonged interruptions were mainly associated with problems related to small-bore feeding tubes (25.5%), increased residual volumes (13.3%), weaning (11.7%), and other reasons (22.8%). Placement and confirmation of placement of the small-bore feeding tube were significant causes of incomplete delivery of nutrients on the day of admission. Conclusions Delivery of enteral nutrition in critically ill patients receiving mechanical ventilation is interrupted by practices embedded in the care of these patients. Evaluation of the process reveals areas to improve the delivery of enteral nutrition.

Download Full-text