Novel Method for Sealing Tracheostomies Immediately after Decannulation—An Acute Clinical Feasibility Study

Author:

Kraghede Rasmus Ellerup123ORCID,Christiansen Karen Juelsgaard2,Kaspersen Alexander Emil2ORCID,Pedersen Michael34,Petersen Johanne Juel3ORCID,Hasenkam John Michael23ORCID,Devantier Louise35

Affiliation:

1. Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, 8200 Aarhus N, Denmark

2. Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, 8200 Aarhus N, Denmark

3. Department of Clinical Medicine, Faculty of Health, Aarhus University, 8200 Aarhus N, Denmark

4. Comparative Medicine Lab, Aarhus University, 8200 Aarhus N, Denmark

5. Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, 8200 Aarhus N, Denmark

Abstract

Tracheostomy decannulation leaves an iatrogenic passage in the upper airways. Inadequate sealing leads to pulmonary dysfunction and reduced voice quality. This study aimed to investigate the feasibility and impact of intratracheal tracheostomy sealing on laryngeal airflow and voice quality immediately after decannulation (ClinicalTrials.gov: NCT06138093). Fifteen adult, tracheostomized, intensive care unit patients were included from our hospital. A temporary, silicone-based sealing disc was inserted in the tracheostomy wound immediately after decannulation. Spirometry with measurement of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF) were performed as measures of airway flow. Voice recordings were assessed using an equal appearing interval scale from 1 to 5. Median FVC, FEV1, PEF, and voice quality score with interquartile range (IQR) was 883 (510–1910) vs. 1260 (1005–1723) mL (p < 0.001), 790 (465–1255) vs. 870 (617–1297) mL (p < 0.001), 103 (55–211) vs. 107 (62–173) mL (p = 0.720), and 2 (1–2.5) vs. 4 (3–5) points (p < 0.001), respectively, with open tracheostomy vs. after sealing the tracheostomy with the intratracheal sealing disc. This feasibility study showed that tracheostomy sealing with the intratracheal disc was safe and led to immediate improvements in FVC, FEV1, and voice quality.

Funder

Novo Nordisk Foundation

Publisher

MDPI AG

Reference34 articles.

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3. AARC Clinical Practice Guideline: Management of Adult Patients with Tracheostomy in the Acute Care Setting;Mussa;Respir. Care,2021

4. Respiratory Muscle Rehabilitation in Patients with Prolonged Mechanical Ventilation: A Targeted Approach;Bissett;Crit. Care,2020

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