Removing a tracheostomy

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curiousgeorge
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Removing a tracheostomy

Postby curiousgeorge » Thu Mar 17, 2016 12:23 pm

My child has a tracheostomy tube and I want to have it removed. What should I do?

(Asked by a parent)

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bachjr
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Re: Removing a tracheostomy

Postby bachjr » Thu Mar 17, 2016 12:24 pm

Although we can routinely decanulate adolescents and adults even when continuously respirator (CTMV) dependent, small children who require CTMV are too frightened to cooperate with decanulation so we wait until they are at least adolescents and hope that the tube will not have caused too much damage to the airways by that time to prevent decanulation. If the child only needs TMV during sleep, however, and cooperate with transition to nasal NVS with a cuffless fenestrated tracheostomy tube in place, they can be safely decanulated as outpatients.

JB
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School


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