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January 16, 2011

U.S. Rep. Gabrielle Gifford Gets a Tracheostomy After 7 Days of Intubation

U.S. Rep. Gabrielle Gifford who is recovering from a gunshot wound to the head 7 days earlier had her breathing tube removed and a tracheostomy tube placed on January 15, 2011.

Many people will wonder why a tracheostomy tube was placed when she's been intubated for only 7 days and even though she has been able to breath on her own since Tuesday. Along with the trach tube, a stomach feeding tube was also placed.

A tracheostomy tube is a small tube placed through an opening in the neck allowing for airway protection, improved ease of breathing, and improved pulmonary care.

It is unusual to keep a patient intubated for greater than 7 days due to risk of tracheal stenosis due to mucosal ulcerations that occur with prolonged intubation. Such ulcerations not only occur in the airway and throat, but also the mouth and lip regions. The exact timing to trach is still controversial however.

However, a tracheostomy tube does appear to speed overall recovery and decrease the number of days of hospitalization.

Though many family members (and patients) may be appalled by the cosmetic appearance of a trach tube, everyone needs to remember a trach tube is TEMPORARY and can be removed without much fuss once the patient regains strength.

Read more about trach here.

Read the Reuters article here.

Watch a video of a trach.



Reference:
Tracheostomy: why, when, and how? Respir Care. 2010 Aug;55(8):1056-68.

Early versus late tracheostomy in patients with acute severe brain injury. J Bras Pneumol. 2010 Feb;36(1):84-91.

Early tracheostomy in intensive care unit: a retrospective study of 506 cases of video-guided Ciaglia Blue Rhino tracheostomies. J Trauma. 2010 Feb;68(2):367-72.

The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients. J Crit Care. 2009 Sep;24(3):435-40. Epub 2009 Jan 17.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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