Management of Tracheostomy: A Survey of Dutch Intensive Care Units
| Autor: | Veelo, Denise P., Schultz, Marcus J., Phoa, Kai Y. N., Dave Dongelmans, Binnekade, Jan M., Spronk, Peter E. |
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| Přispěvatelé: | Other Research, Anesthesiology, Amsterdam institute for Infection and Immunity, Intensive Care Medicine, Other departments |
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | Respiratory care, 53(12), 1709-1715. Daedalus Enterprises Inc. Web of Science |
| ISSN: | 0020-1324 |
| Popis: | OBJECTIVE: To determine tracheostomy-management practices in Dutch intensive care units (ICUs) and post-ICU step-down facilities. METHODS: We surveyed the physician medical directors of all Dutch nonpediatric ICUs that have : 5 beds suitable for mechanical ventilation. The survey asked for demographic information about the hospital and ICU setting, and for information and opinions about tracheostomy management in the ICU and step-down facilities, and the use of tracheostomy-management guidelines. RESULTS: Forty-four of the 69 ICUs responded. Sixty-four percent of the respondent ICUs only deflate the cuff when the patient is breathing spontaneously, without assistance from the ventilator. Fifty-nine percent do not routinely change the tracheostomy tube. Almost half use inner carmulas in tracheostomy tubes. Overall, intensivists were most often involved in the follow-up of discharged tracheostornized patients. In the nonacademic hospitals, specialized ICU nurses were more often involved (P = .05). Sixty-four percent indicated they have no guideline for managing discharged tracheostornized patients. There was a diversity of opinion (median visual-analog-scale score 5.0, 95% confidence interval 3.0 to 8.0) on whether the tracheostomy tube should be removed "at once" or after "down-sizing." CONCLUSIONS: There were large differences in tracheostomy management among Dutch ICUs. ICU and post-ICU tracheostomy-management guidelines are lacking and needed |
| Databáze: | OpenAIRE |
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