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    Tytuł:
    Early or late tracheotomy in patients after multiple organ trauma
    Autorzy:
    Skrzypiec, Łukasz
    Rot, Piotr
    Fus, Maciej
    Witkowska, Agnieszka
    Możański, Marcin
    Jurkiewicz, Dariusz
    Powiązania:
    https://bibliotekanauki.pl/articles/23203232.pdf
    Data publikacji:
    2021-06-30
    Wydawca:
    Index Copernicus International
    Tematy:
    mechanical ventilation
    multi-organ trauma
    tracheotomy
    Opis:
    Introduction: Prolonged mechanical ventilation in patients after multiple organ trauma is an indication for a tracheotomy procedure being performed i.a. to ensure proper hygiene of patient’s airways. Recommendations regarding the optimum timing for the procedure remain ambiguous. Procedures performed before post-operative day 10 are beneficial for the further course of the treatment and patient’s health. Aim: The main objective of the study was to analyze the relationship between the timing of tracheotomy and the length of mechanical ventilation in patients with multiple organ trauma. Secondary objectives included the assessment of the relationships between the timing of tracheotomy and the lengths of intensive care unit (ICU) stay and total hospitalization as well as the incidence of pneumonia and mortality. Material and methods: A retrospective analysis was carried out in 543 patients in whom tracheotomy had been performed at the Clinical Intensive Care Unit of the Military Institute of Medicine in years 2015–2019. Patients were divided into two groups: (1) those subjected to early tracheotomy (prior to hospitalization day 10); and (2) those subjected to late tracheotomy (at day 10 or later). Results: Duration of mechanical ventilation was shorter in patients subjected to early tracheotomy (by 20.3 days on average). The ICU stay and overall hospitalization lengths were also significantly shorter (by the average of 39.4 and 43.1 days, respectively). The mortality rate in patients subjected to early tracheotomy was lower (2%) than in those subjected to late tracheotomy (9%). Pneumonic complications were more common in patients subjected to tracheotomy at hospitalization day 10 or later. Conclusions: Tracheotomy performed within up to 10 days of hospitalization significantly shortens the lengths of mechanical ventilation, ICU stay, and total hospitalization while simultaneously reducing the risk of pneumonia. No correlation has been observed between the timing of tracheotomy and patient mortality rates.
    Źródło:
    Polish Journal of Otolaryngology; 2021, 75, 6; 23-27
    0030-6657
    2300-8423
    Pojawia się w:
    Polish Journal of Otolaryngology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Stosowanie inhalacji przez osoby po laryngektomii całkowitej
    Use of Inhalation after Tracheotomy on the Example of Laryngectomized People
    Autorzy:
    Hamerlińska, Agnieszka
    Kędzierska, Joanna
    Powiązania:
    https://bibliotekanauki.pl/articles/1964839.pdf
    Data publikacji:
    2022-01-09
    Wydawca:
    Polskie Towarzystwo Logopedyczne
    Tematy:
    laryngektomia
    tracheotomia
    rehabilitacja
    inhalacja
    mowa
    laryngectomy
    tracheotomy
    rehabilitation
    inhalation
    speech
    Opis:
    Osoby po laryngektomii, mając rurkę tracheostomijną, zobowiązane są dbać o swoją stomę szyjną. Odpowiednia pielęgnacja udrażnia drogę oddechową; ułatwia odkrztuszanie; nawilża; a tym samym wpływa na charakter głosu, jego zabarwienie oraz ułatwia uczenie się mowy zastępczej. Jednym ze sposobów wspierania tej pielęgnacji jest wykonywanie inhalacji. Celem artykułu jest przedstawienie podejścia osób po laryngektomii do stosowania inhalacji. W badaniu wzięło udział 28 osób. Zastosowano podejście ilościowe, wykorzystano autorską ankietę. Badania przeprowadzono w czerwcu i lipcu 2021 roku. Z badań wynika, że 68% laryngektomowanych stosuje inhalację, jednakże z różną częstotliwością (od kilku razy dziennie po tylko jeden raz w tygodniu). Wielu z nich o metodzie inhalacji uczy się od innych osób laryngektomowanych, a rzadziej od personelu medycznego. Badani dostrzegają pozytywne efekty płynące ze stosowania wziewania.
    Laryngectomy patients are required to take care of their cervical stoma with a tracheostomy tube. Proper care clears the respiratory tract; facilitates expectoration; moisturizes; thus affects the character of the voice, its color and facilitates learning replacement speech. One way to support this care is by inhalation. The aim of the article is to present the approach of people after laryngectomy to the use of inhalation. 28 people participated in the study. A quantitative approach and original questionnaire was used. The research was conducted in June and July 2021. The research shows that 68% of laryngectomees use inhalation, however with different frequency (from several times a day to only once a week). Many of them learn about the inhalation method from other laryngectomees, and less often from medical personnel. The respondents see the positive effects of inhaling.
    Źródło:
    Logopedia; 2021, 50, 2; 157-167
    0459-6935
    Pojawia się w:
    Logopedia
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Fungal colonisation of tracheotomy tubes in patients diagnosed with larynx cancer
    Autorzy:
    Gniadek, A.
    Krzysciak, P.
    Hawryszuk, A.
    Wojcikowska, K.
    Powiązania:
    https://bibliotekanauki.pl/articles/6408.pdf
    Data publikacji:
    2016
    Wydawca:
    Polskie Towarzystwo Parazytologiczne
    Tematy:
    fungal colonization
    fungi
    Aspergillus fumigatus
    Aspergillus flavus
    Candida albicans
    tracheotomy
    tube
    risk factor
    patient
    larynx cancer
    Źródło:
    Annals of Parasitology; 2016, 62, Suppl.
    0043-5163
    Pojawia się w:
    Annals of Parasitology
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Acute dyspnea as a manifestation of Forestiers disease. A case report
    Autorzy:
    Kuryłowicz, Jagoda
    Stodulski, Dominik
    Garsta, Ewa
    Mikaszewski, Bogusław
    Powiązania:
    https://bibliotekanauki.pl/articles/1398952.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    acute laryngeal dyspnea
    diffuse idiopathic skeletal hyperostosis
    dysphagia
    Forestier’s disease
    laryngeal oedema
    otolaryngological symptoms
    stridor
    tracheotomy
    Opis:
    Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a noninflammatory disease and is characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. Although, usually, DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor Case report: In differential diagnosis of upper respiratory tract symptoms, we should consider DISH. We present case of 82-years old male patient with acute dyspnea, who was diagnosed with osteophytes of C4–C7 vertebral bodies. In this case conservative therapy was not efficient, therefore successful surgical treatment was performed. BMI – Body Mass IndexCRP – C Reactive Protein CT – computed tomography DISH – diffuse idiopathic skeletal hyperostosis GERD – gastro-esophageal reflux disease MRI – magnetic resonance imaging NSAIDs – nonsteroidal anti-inflammatory drugs ORL PPI – proton pump inhibitors Diffuse idiopathic skeletal hypMRerostosis (DISH), also known as Forestier’s disease, was first described under the name “senile ankylosing hyperostisis of the spine” by Jacques Forestier in 1950 [1]. It is a noninflammatory disease, characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. It may also involve enthesopathy of the extremities. Forestier’s disease is a rather common condition, which affects approximately 40% of older (>65 years old) male patients. Prevalence of DISH increases with age (56% for age >80 years old), BMI and blood pressure [2] and is associated with diabetes mellitus, elevated insulin-like growth factor and hyperuricemia [3].Although usually DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor [4–10]. null null null null An 82-years old man was admitted to the Department of Otolaryngology due to acute dyspnea with stridor at rest. Respiratory disorder was progressing for 2 months. Moreover, patient complained of dysphagia and hoarseness, which were present for a year. The patient was diagnosed with GERD and treatment was administrated. Medical history was significant of duodenal ulcer with perforation and prostate cancer treated with hormonal therapy for 13 months. Flexible nasopharyngoscopy revealed large mass protruding from the posterior wall of hypopharynx and oedema, which concealed interarytenoid notch and partly rima glottis (Fig. 1.). No other abnormalities in ORL examination were present. Increased CRP level and impaired fasting glucose were found in laboratory tests during hospitalization. CT (Fig. 2.) and MRI (Fig. 3.) revealed massive osteophytes on the anterior part of vertebral bodies C4–C7 without intervertebral disc space narrowing, thickened vestibular folds and peri-arytenoid region. X-ray revealed no changes in sacro-iliac joints. Hypopharyngoscopy and microlaryngoscopy were performed in due to rule out neoplastic changes. Antibiotis, steroids and high doses of PPI (proton pump inhibitors) were administered, resulting in oedema decrease and resolution of the symptoms. After 7 months patient was hospitalized again, due to acute dyspnea and stridor. Increased CRP level was found in laboratory tests. Despite conservative therapy (corticosteroids, antibiotics and PPI) no significant respiratory improvement was achieved, therefore decision on surgical treatment was made. Patient was referred to the Department of Neurosurgery where, after elective tracheotomy, cervical osteophytes (C2–C5) were removed, using an anterolateral transcervical approach, without any complications (Fig. 4.). Because of postoperative laryngeal and hypopharyngeal oedema, steroid therapy was maintained. Decannulation was performed on 7th postoperative day, although patient complained of more severe dysphagia with aspiration while swallowing. Nasogastric feeding tube was inserted for 3 weeks. At the 6-month follow up dyspnea and dysphagia are absent, patient successfully swallows solid food and liquids. Endoscopic examination revealed only small protrusion and minor oedema on posterior wall of hypopharynx on the level of arytenoids (Fig. 5., 6.). null null Forestier’s disease otolaryngological manifestations are extremely rare. The most common symptom is dysphagia, aside from it aspiration [11], dyspnea (with or without stridor) and hoarseness [4].Our patient’s main complaint and reason of hospitalization was dyspnea, while dysphagia was secondary problem. Foregoing symptoms can occur not only due to osteophytes compression on larynx and esophagus, but also because of chronic inflammation and chronic or recurrent edema caused by mechanic irritation. Other symptoms, such as aspiration while swallowing, can be caused by impaired movability of epiglottis or vocal chords [8, 11].In presented case symptoms (especially dyspnoe) were increasing during upper respiratory tract infections and due to exacerbation of GERD.In literature authors described similar cases, where inflammation led to oedema, chronic or remitting during infection, which worsened patient’s condition [12, 13] and caused respiratory decompensation, necessitating even urgent tracheotomy [10].During diagnosis of DISH with otolaryngologic manifestations, mirror laryngoscopy and fiberoscopy should be performed. It can reveal fine, firm protrusion on the posterior wall of pharynx, accompanied by oedema and impaired movability of larynx [8].In differential diagnosis of protrusion on the posterior wall of pharynx we should consider retropharyngeal pathologies, such as malignant tumors (including lymphoma), benign tumors, metastases, congenital defects (e.g. vascular malformations), lymphadenopathy, retropharyngeal abscess or massive oedema. Imaging (CT, MRI) can rule out these diseases [14].Forestier’s disease should also be distinguished from other pathologies, which involve vertebral bodies, including ankylosing spondylitis, osteophytes in osteoarthritis or osteomas [3]. Differential diagnosis can be based on Resnick’s radiological classification criteria of DISH [15]: presence of flowing calcification and ossification along with the anterolateral aspects of at least four contiguous vertebral bodies, relative preservation of intervertebral disc height in the involved vertebral segments and absence of apophyseal joint bony ankylosis and sacro-iliac joint erosion, sclerosis or bony fusion.In cases with dysphagia being the main patient’s complaint, esophagogram with barium swallowing should be performed [5, 9, 11]. Elective panendoscopy with biopsy should always be considered to rule out neoplasm [5, 16].If DISH is diagnosed accidently in imaging, we can assume an expectant attitude. Conservative treatment with NSAIDs, steroids and dietary measures can be introduced in cases without weight loss and with minor respiratory symptoms. Gastroesophageal reflux can be symptom-worsening factor, therefore PPI treatment should be considered. If conservative treatment is not effective, osteophytes’ surgical removal is recommended, preferably using anterolateral approach [16].In our case, conservative therapy was not sufficient. Massive hypopharyngeal oedema and stridor were present in spite of high doses of corticosteroids. Due to the pre-operative oedema we decided to perform an elective tracheotomy before neurosurgical intervention, to avoid possible complications [13].It is remarkable, that after surgery dyspnea resolved after few days, whilst dysphagia and aspiration worsened in post-operative time and nasogastric tube insertion was necessary.Authors present this case in aim to draw attention to Forestier’s disease as possible reason for respiratory and gastrointestinal symptoms among elderly people.
    Źródło:
    Polski Przegląd Otorynolaryngologiczny; 2021, 10, 1; 49-52
    2084-5308
    2300-7338
    Pojawia się w:
    Polski Przegląd Otorynolaryngologiczny
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
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