scholarly journals Tracheal Stoma Closure and Outcomes in Tracheotomy Patients

2021 ◽  
Vol 12 (1) ◽  
pp. 9-14
Author(s):  
Shigeru Kasugai ◽  
Yasuhiro Miyamoto ◽  
Masahiko Fukasawa ◽  
Koshi Mikami ◽  
Yoshimitsu Saito ◽  
...  
Keyword(s):  
Author(s):  
Karina Dyrvig Honoré ◽  
Malene Nygaard Johansen ◽  
Lars Rasmussen ◽  
Gitte Zachariassen

Abstract Introduction Very preterm infants (VPIs) surgically treated for necrotizing enterocolitis (NEC) are at risk of growth retardation. The aim of this study was to demonstrate and compare growth during the first 6 years of life in VPIs with stoma after NEC surgery with VPIs without NEC surgery. Materials and Methods We included all VPIs surgically treated due to NEC at the Odense University Hospital from August 1, 2004, to July 31, 2008. Outcome on growth was compared with a group of VPIs without NEC. The VPIs with NEC were identified searching the local database using the International Classification of Diseases, 10th Revision diagnosis of NEC (DP77.9). Data on growth were collected from medical files and if not present, the parents reported the data. Results Nineteen VPIs, surgically treated due to NEC, survived to 6 years of age. Median gestational age was 283/7 weeks (245/7–313/7). Median age at NEC surgery and stoma formation was 2.3 weeks (0.1–6.3) and median age at stoma closure was 2.5 months corrected age (CA) (postmenstrual age 36 weeks to CA 6.7 months). Compared with the non-NEC group, VPIs with NEC and stoma demonstrated poor growth, especially in head circumference (HC) with no increase in growth velocity before the time of stoma closure between 2.5- and 3-month CAs. Conclusion Our findings demonstrate poor growth in VPIs after NEC surgery and improved HC growth after stoma closure.


2015 ◽  
Vol 25 (3) ◽  
pp. 449-457 ◽  
Author(s):  
Y.-H. Lin ◽  
H.-Y. Yang ◽  
S.-L. Hung ◽  
H.-P. Chen ◽  
K.-W. Liu ◽  
...  

1996 ◽  
Vol 80 (5) ◽  
pp. 1595-1604 ◽  
Author(s):  
I. Kobayashi ◽  
A. Perry ◽  
J. Rhymer ◽  
B. Wuyam ◽  
P. Hughes ◽  
...  

To investigate the relationship between the electrical activity of the genioglossus (GG-EMG) and associated tongue movement, seven laryngectomized subjects breathing through a tracheal stoma (without pressure or flow change in the upper airway) were studied in the supine position. Tongue movement, with the use of lateral fluoroscopy, and GG-EMG expressed as a percentage of maximum voluntary genioglossal activation were monitored simultaneously during 1) spontaneous inspiration (SI), 2) resistive loaded inspiration (LI), and 3) rapid inspiration (RI). Tongue position during each maneuver was compared with its position during spontaneous expiration. Peak GG-EMG during the three maneuvers was significantly different from each other (SI: 5.4 +/- 1.6, LI: 11.9 +/- 1.8, and RI: 51.6 +/- 9.4 (SE) %, respectively). Associated forward movement of the posterior aspect of the tongue was minimum during SI; however, significant movement was observed during LI, and this was increased during RI. Significant covariance existed between peak GG-EMG and this movement. Genioglossal coactivation with inspiration enlarges the glossopharyngeal airway, particularly in its caudal part. In subjects with intact upper airways, this activation may protect or enhance upper airway patency in an effort-dependent manner.


2021 ◽  
Vol 64 ◽  
pp. 101695
Author(s):  
John Gerard Cassey ◽  
Paul Heinrich Liebenberg ◽  
Scott Nightingale ◽  
Sandeep Kumar Gupta
Keyword(s):  

2020 ◽  
Vol 27 (3) ◽  
pp. 291-298
Author(s):  
Yinyin Guo ◽  
Yanxin Luo ◽  
Hui Zhao ◽  
Liangliang Bai ◽  
Juan Li ◽  
...  

Background. A substantial proportion of patients undergoing colorectal surgery receive a temporary stoma, and the timing for stoma closure remains unclear. The aim of this study was to evaluate the safety and feasibility of early stoma closure (ESC) compared with routine stoma closure (RSC) after colorectal surgery. Methods. We comprehensively searched PubMed, Embase, and the Cochrane Library for randomized controlled trials that compared ESC and RSC after colorectal surgery. Results. A total of 7 randomized controlled trials with 814 enrolled patients were identified for this meta-analysis. There were no significant differences between the ESC and RSC groups regarding the complications of stoma closure (26.8% and 16.6%, respectively; odds ratio [OR]: 1.30; 95% confidence interval [CI]: 0.89-1.90; P = .17). A subgroup analysis was conducted by Clavien-Dindo grade of complication, and no significant difference was observed in any subgroup ( P > .05). However, the ESC group had a significantly higher risk of wound complications than the RSC group (17.6% and 7.8%, respectively; OR: 2.61; 95% CI: 1.43-4.76; P = .002), and the RSC group had more cases of small bowel obstruction than the ESC group (3.1% and 8.4%, respectively; OR: 0.37; 95% CI: 0.15-0.87; P = .02). Conclusions. ESC is a safe and effective therapeutic approach in patients who have undergone colorectal surgery; it is associated with a reduced risk of bowel obstruction but a higher risk of wound complications.


2016 ◽  
Vol 44 (12) ◽  
pp. 460-460
Author(s):  
Lindsey Armstrong ◽  
Mary Arbuthnot ◽  
David Mooney

1991 ◽  
Vol 70 (3) ◽  
pp. 1284-1289 ◽  
Author(s):  
P. W. Davenport ◽  
D. J. Dalziel ◽  
B. Webb ◽  
J. R. Bellah ◽  
C. J. Vierck

The physiological mechanisms mediating the detection of mechanical loads are unknown. This is, in part, due to the lack of an animal model of load detection that could be used to investigate specific sensory systems. We used American Foxhounds with tracheal stomata to behaviorally condition the detection of inspiratory occlusion and graded resistive loads. The resistive loads were presented with a loading manifold connected to the inspiratory port of a non-rebreathing valve. The dogs signaled detection of the load by lifting their front paw off a lever. Inspiratory occlusion was used as the initial training stimulus, and the dogs could reliably respond within the first or second inspiratory effort to 100% of the occlusion presentations after 13 trials. Graded resistances that spanned the 50% detection threshold were then presented. The detection threshold resistances (delta R50) were 0.96 and 1.70 cmH2O.l-1.s. Ratios of delta R50 to background resistance were 0.15 and 0.30. The near-threshold resistive loads did not significantly change expired PCO2 or breathing patterns. These results demonstrate that dogs can be conditioned to reliably and specifically signal the detection of graded inspiratory mechanical loads. Inspiration through the tracheal stoma excludes afferents in the upper extrathoracic trachea, larynx, pharynx, nasal passages, and mouth from mediating load detection in these dogs. It is unknown which remaining afferents (vagal or respiratory muscle) are responsible for load detection.


1982 ◽  
Vol 75 (4) ◽  
pp. 512-513 ◽  
Author(s):  
C. RON CANNON
Keyword(s):  

2003 ◽  
Vol 13 (2) ◽  
pp. 369-373 ◽  
Author(s):  
K.Robert Shen ◽  
Douglas J. Mathisen
Keyword(s):  

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