Use of a noninvasive ventilation device following tracheotomy: an alternative to facilitate ICU discharge?

Blanco, Jacobo Bacariza; Esquinas, António M.

doi:10.5935/0103-507x.20130059

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…In addition, from the economic aspect, there are also scholars who recognize this method. 51 But the relatively conservative view is that, because of the many aspects involved, this choice should be made after discussion by a multidisciplinary team, 52 and that NIV should take precedence over IMV whenever possible to avoid the risk of ventilator and catheter-related complications. 46 Obviously, these concerns are primarily about the complications of tracheotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Hill 50 has asserted that noninvasive ventilators can be used for PSV-and PEEP-related ventilation in patients with tracheostomy. Ibrahim et al 12 proposed that the use of a noninvasive portable ventilator connected to tracheostomy tube may be an alternative for patients who cannot wean and discharge from hospital. In addition, from the economic aspect, there are also scholars who recognize this method.…”

Section: Interfaces Of Noninvasive Ventilatorsmentioning

confidence: 99%

“…Several early studies have demonstrated that noninvasive ventilator is safe and effective not only in providing noninvasive pressure support for patients with respiratory failure, 8 , 9 but also in providing invasive ventilation support for stable patients with tracheostomy tubes. 10 There have been previous reports of patients using noninvasive ventilators via tracheotomy, 11 , 12 and with the advances in ventilator technology, the functions of these ventilators have become more comprehensive and integrated. In recent years, ‘portable ventilators’ with both noninvasive and invasive modes are on the market, such as Stellar 150, Astral 150, LTV series, PB 540, iVent 101, and T-Bird series.…”

Section: Introductionmentioning

confidence: 99%

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Long-term home mechanical ventilation using a noninvasive ventilator via tracheotomy in patients with myasthenia gravis: a case report and literature review

Liu

Shi

2023

Ther Adv Respir Dis

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Neuromuscular diseases (NMD) are indications for long-term home mechanical ventilation (HMV). Noninvasive ventilation is preferred to HMV. However, invasive mechanical ventilation (IMV) is more appropriate if the patient has uncontrollable airway secretions, the possibility of aspiration, failure to wean, or severe weakness of the respiratory muscles. But if the patient undergoes multiple intubation or tracheotomy, it will be more painful and unbearable. For some end-stage NMD patients who need long-term tracheostomy, HMV using noninvasive ventilator via tracheotomy may be a conservative care option. An 87-year-old male with myasthenia gravis underwent repeated IMV and failed to wean. We used a noninvasive ventilator connected to a tracheostomy tube for mechanical ventilation. One and a half years later, the patient weaned successfully. However, there was a lack of evidence-based medicine and standardized guidelines in such areas as indications, contraindications, and ventilator parameter setting. For the systematic review, a literature search was performed in PubMed, Embase, Cochrane, and CNKI (China National Knowledge Infrastructure) to identify reported cases of using noninvasive ventilator in patients undergoing tracheostomy. A total of 72 cases who performed ventilation via tracheotomy tube were identified. The main diagnoses included NMD, chronic obstructive pulmonary disease (COPD), pneumonia, and congenital central hypoventilation syndrome (CCHS). Indications included dysfunctional ventilatory weaning response (DVWR), apnea and cyanosis. Clinical outcome was as follows: 33 patients were weaned, and 24 patients underwent HMV. A total of 288 cases who performed ventilation through the mask after blocking the tracheostomy tube were identified. The primary diagnoses included COPD, NMD, thoracic restriction, spinal cord injured (SCI), and CCHS. Indications included DVWR, apnea and cyanosis, routine weaning. Clinical outcome was as follows: successful tracheostomy tube decannulations were performed in 254 patients and failed in 33 patients. So, in patients requiring HMV, selection of noninvasive ventilation (NIV) or IMV should be individualized. Tracheostomy preservation should be considered in some patients with advanced NMD if there is respiratory muscle weakness or the risk of aspiration. And attempts can be made to use a noninvasive ventilator because of its advantages of portability, ease of operation, and low cost. Noninvasive ventilators can be used in patients with tracheotomy, whether direct connection tracheotomy or mask ventilation after the tube is capped, especially in weaning and tracheostomy tube decannulation.

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Section: Discussionmentioning

confidence: 99%

Section: Interfaces Of Noninvasive Ventilatorsmentioning

confidence: 99%