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National recommendations for tracheotomy and for tracheostomy care
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2017 (English)In: Abstracts from the Scandinavian Society of Anesthesiology and Intensive Care Medicine 34th Congress, John Wiley & Sons, 2017, Vol. 61, p. 1034-1035, article id 118Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Every year 2000 tracheotomies are performed in Sweden. Severe or lethal complications and shortcomings in the valuation of risks pre-, per- and postoperatively occurs. This work intends, based on best available evidence, to reduce injuries related to tracheotomy.

Material and Method: Anaesthesiologists and otorhinolaryngologists from University Hospitals compiled a document with guidelines to reduce risks to cause severe complications and death at tracheotomy operations. Landstingens Omse- € sidiga Fors € €akringsbolag (LOF, Swedish insur- € ance company for publicly funded health care providers) also took part.

Results: Surgical tracheotomy is recommended for children and adults with known or expected difficult intubation such as Cormack-Lehane IIIIV, short/thick neck, distance between cricoid cartilage and jugulum<15 mm, neck circumference >45 cm, tumors in head and neck area, BMI >35, rheumatoid arthritis, severe obstructive sleep apnea syndrome, high intracranial pressure, unstable neck fracture and coagulopathies. Acta Anaesthesiologica Scandinavica 61 (2017) 962–1062 1034 ª 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd SSAI ABSTRACTS Percutaneous tracheostomy (PCT) could be performed in intensive care patients. A tracheotomy cannula with an inner cannula should be used. Common complications include acute obstruction of tracheal cannula, dislocation, emphysema of the neck, trauma to dorsal tracheal wall. Some deaths have occurred due to lack of education to perform a surgical tracheotomy in patients where percutaneous tracheostomy were not possible to perform.

Conclusion: Tracheotomy should be performed at hospitals where competence exist for surgical tracheotomy, including patients with difficult anatomy, regardless of the tracheotomy technique. At each hospitals the distribution between percutaneous and surgical tracheostomies must be weighted as to preserve overall competence for both techniques. A guideline of acute tracheal cannula occlusion is presented (Figure). 

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 61, p. 1034-1035, article id 118
Series
Acta Anaesthesiologica Scandinavica, ISSN 1399-6576
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-158674DOI: 10.1111/aas.12941OAI: oai:DiVA.org:umu-158674DiVA, id: diva2:1313929
Conference
The Scandinavian Society of Anesthesiology andIntensive Care Medicine 34th Congress, in conjunction with the Swedish Society of Anesthesiology and Intensive Care Medicine Annual Meeting, Malmö, Sweden, September 6-8, 2017
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-08Bibliographically approved

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Olofsson, Katarina

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