Importance of flexible bronchoscopy in decannulation of tracheostomy patients
OBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheost...
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doaj-110b9e15c9054fd8b470975a082227192020-11-25T01:54:56ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-4546422758010.1590/0100-69912015002003S0100-69912015000300075Importance of flexible bronchoscopy in decannulation of tracheostomy patientsLeonardo Brand RodriguesTarcizo Afonso NunesOBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheostomized patients aged between 19 and 87 years, with tracheal stent for a mean of 46 ± 28 days and with clinical criteria for decannulation. They were submitted to tracheostomy tube occlusion tolerance testfor 24 hours, and then to flexible bronchoscopy. We described and classified the diagnosed laryngotracheal changes. We compared the clinical criteria for decannulation indication with the bronchoscopy-diagnosed laryngotracheal injuries that contraindicated decannulation. We identified the factors that could interfere in decannulation and evaluated the importance of bronchoscopy as part of the process. RESULTS: Forty (80.4%) patients had laryngotracheal alterations. Of the 40 patients considered clinically fit to decannulation, eight (20%) (p = 0.0007) presented with laryngotracheal injuries at bronchoscopy that contraindicated the procedure. The most frequent laryngeal alteration was vocal cords lesion, in 15 (29%) individuals, and granuloma, the most prevalent tracheal lesion, in 14 (27.5%) patients. CONCLUSION: flexible bronchoscopy showed a large number of laryngotracheal injuries, the most frequent being the vocal cords injury in the larynx and the granuloma in the trachea, which contributed to increase the decannulation procedure safety.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000300075&lng=en&tlng=enBronchoscopyTracheostomyTracheal diseasesTracheomalaciaIntubation, Intratracheal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Leonardo Brand Rodrigues Tarcizo Afonso Nunes |
spellingShingle |
Leonardo Brand Rodrigues Tarcizo Afonso Nunes Importance of flexible bronchoscopy in decannulation of tracheostomy patients Revista do Colégio Brasileiro de Cirurgiões Bronchoscopy Tracheostomy Tracheal diseases Tracheomalacia Intubation, Intratracheal |
author_facet |
Leonardo Brand Rodrigues Tarcizo Afonso Nunes |
author_sort |
Leonardo Brand Rodrigues |
title |
Importance of flexible bronchoscopy in decannulation of tracheostomy patients |
title_short |
Importance of flexible bronchoscopy in decannulation of tracheostomy patients |
title_full |
Importance of flexible bronchoscopy in decannulation of tracheostomy patients |
title_fullStr |
Importance of flexible bronchoscopy in decannulation of tracheostomy patients |
title_full_unstemmed |
Importance of flexible bronchoscopy in decannulation of tracheostomy patients |
title_sort |
importance of flexible bronchoscopy in decannulation of tracheostomy patients |
publisher |
Colégio Brasileiro de Cirurgiões |
series |
Revista do Colégio Brasileiro de Cirurgiões |
issn |
1809-4546 |
description |
OBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheostomized patients aged between 19 and 87 years, with tracheal stent for a mean of 46 ± 28 days and with clinical criteria for decannulation. They were submitted to tracheostomy tube occlusion tolerance testfor 24 hours, and then to flexible bronchoscopy. We described and classified the diagnosed laryngotracheal changes. We compared the clinical criteria for decannulation indication with the bronchoscopy-diagnosed laryngotracheal injuries that contraindicated decannulation. We identified the factors that could interfere in decannulation and evaluated the importance of bronchoscopy as part of the process. RESULTS: Forty (80.4%) patients had laryngotracheal alterations. Of the 40 patients considered clinically fit to decannulation, eight (20%) (p = 0.0007) presented with laryngotracheal injuries at bronchoscopy that contraindicated the procedure. The most frequent laryngeal alteration was vocal cords lesion, in 15 (29%) individuals, and granuloma, the most prevalent tracheal lesion, in 14 (27.5%) patients. CONCLUSION: flexible bronchoscopy showed a large number of laryngotracheal injuries, the most frequent being the vocal cords injury in the larynx and the granuloma in the trachea, which contributed to increase the decannulation procedure safety. |
topic |
Bronchoscopy Tracheostomy Tracheal diseases Tracheomalacia Intubation, Intratracheal |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912015000300075&lng=en&tlng=en |
work_keys_str_mv |
AT leonardobrandrodrigues importanceofflexiblebronchoscopyindecannulationoftracheostomypatients AT tarcizoafonsonunes importanceofflexiblebronchoscopyindecannulationoftracheostomypatients |
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