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Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 12/2017

01-12-2017 | Correspondence

Weaning from mechanical ventilation using tracheostomy cuff deflation and a one-way speaking valve: a historical-cohort series

Authors: Stephen Kowalski, MD, FRCPC, Renée El-Gabalawy, MA, PhD, Kandy Macaulay, RRT, Rhonda Thorkelsson, RN, CNCC, Adrian Robertson, MD, FRCPC, Zoheir Bshouty, MD, FRCPC, Linda Girling, BScHons

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 12/2017

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Excerpt

To the Editor,
Table
Course of ventilation in patients with a speaking valve tracheostomy
Patient #
Diagnosis
Intubation to speakinga (days)
Speaking to liberation (days)
Intubation to liberationb (days)
Duration of initial SVT (min)
1
Stroke
89
NA
246
60
2
MVA-SCI
45
NA
233
2
3
GBS+
65
26
91
480
4
Pancreatitis
140
3
143
240
5
Pancreatitis
62
12
74
60
6
Lung transplant
52
45
97
360
7
MVA++
168
39
207
240
8
GBS+
53
16
69
60
9
Colon resection
19
13
32
720
10
MVA-SCI+++
97
15
112
30
11
Lower GI bleed
83
21
104
60
12
Lung transplant
33
8
41
720
13
MVA++
39
22
61
240
14
Stab to aorta
72
38
133
5
15
Myasthenia gravis
72
30
102
240
16
Aspiration pneumonia
51
28
79
60
17
MVA-SCI+++
59
3
62
60
Mean (SD)c
 
71 (39)
21 (13)
94 (44)
238 (238)
aIntubation to speaking: time from initial intubation until the tracheostomy cuff was deflated, with a speaking valve in place, for two consecutive days
bIntubation to liberation: time from the initial intubation until the patient was breathing unassisted for 48 consecutive hours
cValues for patients 3–17 only
GBS = Guillain-Barre syndrome; MVA = motor vehicle accident; SCI = spinal cord injury. SVT = speaking valve trial
Literature
1.
go back to reference Martin AD, Smith BK, Gabrielli A. Mechanical ventilation, diaphragm weakness and weaning: a rehabilitation perspective. Respir Physiol Neurobiol 2013; 189: 377-83.CrossRef Martin AD, Smith BK, Gabrielli A. Mechanical ventilation, diaphragm weakness and weaning: a rehabilitation perspective. Respir Physiol Neurobiol 2013; 189: 377-83.CrossRef
2.
go back to reference Jubran A, Grant BJ, Duffner LA, et al. Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation a randomized trial. JAMA 2013; 309: 671-7.CrossRefPubMedPubMedCentral Jubran A, Grant BJ, Duffner LA, et al. Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation a randomized trial. JAMA 2013; 309: 671-7.CrossRefPubMedPubMedCentral
3.
go back to reference Khalaila R, Zbidat W, Anwar K, Bayya A, Linton DM, Sviri S. Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. Am J Crit Care 2011; 20: 470-9.CrossRefPubMed Khalaila R, Zbidat W, Anwar K, Bayya A, Linton DM, Sviri S. Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation. Am J Crit Care 2011; 20: 470-9.CrossRefPubMed
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go back to reference Patak L, Gawlinski A, Fung NI, Doering L, Berg J. Patients’ reports of health care practitioner interventions that are related to communication during mechanical ventilation. Heart Lung 2004; 33: 308-20.CrossRefPubMed Patak L, Gawlinski A, Fung NI, Doering L, Berg J. Patients’ reports of health care practitioner interventions that are related to communication during mechanical ventilation. Heart Lung 2004; 33: 308-20.CrossRefPubMed
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Metadata
Title
Weaning from mechanical ventilation using tracheostomy cuff deflation and a one-way speaking valve: a historical-cohort series
Authors
Stephen Kowalski, MD, FRCPC
Renée El-Gabalawy, MA, PhD
Kandy Macaulay, RRT
Rhonda Thorkelsson, RN, CNCC
Adrian Robertson, MD, FRCPC
Zoheir Bshouty, MD, FRCPC
Linda Girling, BScHons
Publication date
01-12-2017
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 12/2017
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-017-0964-3

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