Disease relevance of Tracheotomy

• Granulomas developed in 40 children (80%) and were unrelated to age, sex, race, gastroesophageal reflux, tracheotomy duration, or type of stenosis [1].
• C5 root weakness was seen in four patients (3.8%); two patients experienced acute airway obstruction, of which one required tracheotomy [2].
• Management of subglottic hemangioma in Sophia Children's Hospital is primarily intralesional steroids and intubation and secondarily submucous resection or tracheotomy [3].
• Important points to consider during this process are: a formal tracheostomy rather than a tracheotomy; other potential sites of obstruction than the laryngeal stenosis; gastroesophageal reflux; prevention and control of infection and the use of prophylactic antibiotics; method and type of suture material; stenting; movement and method of feeding [4].
• The APACHE II score, coma, hypoalbuminemia, mechanical ventilation, tracheotomy, presence of nasogastric tube were found as independent risk factors [5].

High impact information on Tracheotomy

• We anesthetized 16 rabbits (halothane, 0.8%) and mechanically ventilated them through a tracheotomy [6].
• Upper airway humidification, measured from the moisture gained by dry air passed through the upper airways in mice breathing through a tracheotomy, decreased from 91 to 50% with increasing ventilation from 20 to 220 ml/min, and reduced by 3-5% in AQP3/AQP4 knockout mice [7].
• 2. In cats anaesthetized with sodium pentobarbitone and breathing spontaneously following tracheotomy, the left sciatic and femoral nerves were electrically stimulated at 3 Hz for 20 min to induce muscle contraction, and hindlimb blood flow was measured with a flow probe [8].
• After tracheotomy, median (25th, 75th percentiles) fentanyl and midazolam administration decreased from 866 (191, 1672) to 71 (3, 426) microg/(patient.day) and from 44 (16, 128) to 7 (1, 42) mg/(patient.day) (p < .001), respectively [9].
• Patients' sedation levels (according to the Riker's 7-level sedation-agitation score) and intravenous (fentanyl and midazolam) and oral (clorazepate and haloperidol) sedative administration were measured daily during the 7 days before and after tracheotomy [9].

Biological context of Tracheotomy

• After tracheotomy and during mechanical ventilation, the changes in the heart rate, mean arterial pressure, and RSNA in response to random exposures to 1%, 2%, 3%, and 4% isoflurane were examined [10].
• We performed tracheotomies on 12 mongrel dogs anesthetized with sodium pentobarbital and compared the effects of rebreathing and lung inflation on LVP activities with those on LCA and PCA activities [11].

Anatomical context of Tracheotomy

• A technique has been described for emergency tracheotomy in a patient with massive neck swelling which utilizes the hyoid bone to permit localization of the midline of the neck and manual surgical traction of the larynx [12].
• In contrast, tracheotomy abolishes the fast wave response to toluene presentation to the snout unless the toluene vapor is drawn into the nasal passages by suction at the rostral end of the severed trachea [13].
• N-nitro-L-arginine, a competitive inhibitor of endothelium-derived NO synthase, was infused into the left pulmonary artery, and tracheotomy was placed [14].

Associations of Tracheotomy with chemical compounds

• We performed tracheotomies on 12 mongrel dogs anesthetized with sodium pentobarbital and found that lung inflation augmented the activity of the levator veli palatini muscle (LVP) [15].
• METHODS: In rats anesthetized with halothane, nitrous oxide, and oxygen, tracheotomy was performed and the lungs were mechanically ventilated [16].
• After 1 wk of recovery, the animals underwent tracheotomy and were subjected to intravenous infusions of endotoxin 10 ng x kg-1 x min-1 and isotonic saline 3 mL x kg-1 x hr-1 for 8 hrs [17].
• After a tracheotomy had been performed, the sheep were randomized into sham, control, and gentamicin groups (n = 6 each) [18].
• Complication rates included the following: conservative monitoring (none), corticosteroid (18%), tracheotomy (none), CO2 laser (12%), interferon (20%), and laryngotracheoplasty (20%) [19].

Gene context of Tracheotomy

• Sixteen patients used part-time NPPV for 17.5 +/- 13.0 months (maximum, 25 months), then full-time NPPV for 14.1 +/- 12.6 months (maximum, 40 months) before undergoing tracheotomy [20].
• Late complications included symptomatic gastroesophageal reflux (60%), anastomotic strictures (40%), and severe tracheomalacia requiring long-term tracheotomy (20%) [21].
• High grade obstruction, involvement of the soft tissue of the neck, and tracheal deviation can make intubation and tracheotomy hazardous, if not impossible [22].
• Analysis by Fisher's Exact Test revealed patients with a syndromic diagnosis to have a significantly higher rate for tracheotomies and gastrostomy tube placement (P = .041, and P = .0004, respectively) [23].
• Five underwent regular tracheotomy (RT) and six underwent SPT [24].

Analytical, diagnostic and therapeutic context of Tracheotomy

• The coronal (lateral) diameter and the cross-sectional area at the level of the stoma were 4.7 mm (SEM, 0.23 mm) and 41 mm2 (SEM, 3.0 mm2) after open tracheotomy, versus 8.1 mm (SEM, 0.13 mm) and 58 mm2 (SEM, 4.6 mm2) after PDT (P < .001 and P = .023, respectively) [25].
• CONCLUSION: This limited experience on the endoscopic repair of extrathoracic LTEC shows that a minimally invasive approach sparing the need for postoperative intubation or tracheotomy is feasible and safe if modern technology (ultrapulse CO2 laser, endoscopic suturing, and postoperative use of CPAP in the intensive care unit) is available [26].
• Prognostic value of Glasgow Coma Scale for tracheotomy in head injured patients [27].
• A modified occlusal splint to avoid tracheotomy for total midface osteotomies [28].
• Following craniotomy and tracheotomy for artificial ventilation, surface PO2 of the cerebro-cortex and cerebral blood flow via the inhalatory hydrogen clearance technique were measured [29].

References