Tracheal Stenosis Following Tracheostomy
Conditions
Brief summary
After respiratory weaning, decannulation is sought. To do this, the tracheal cannula is first unblocked, so that patients no longer breathe in and out through the cannula, but (at least partially) passing the cannula by the natural route. In the presence of tracheal stenosis there is increased breathing effort, possibly restlessness and stridor. This constellation of symptoms suggests the suspicion of tracheal stenosis, so in the next step a tracheoscopy is performed to confirm or exclude tracheal stenosis. In case of symptomatic tracheal stenosis and at least 30-50% stenosis of the trachea (clinical symptoms can be expected from a 30-50% stenosis) then appropriate therapy (here: cryotherapy, other techniques only in exceptional cases) is planned. The goal is to be able to remove the tracheal cannula (long term) after successful therapy, so that patients do not have to be permanently provided with a tracheal cannula. There is no definitive/evidence-based standard therapy for the treatment of tracheal stenosis. Cryotherapy is a gentle therapy that has already been applied and described for the treatment of tracheal stenosis (see above). The examination is performed as part of an analgesic dose, as is routine for a bronchoscopy (in-house SOP). After treatment, a follow-up is planned for about 10 days later.
Interventions
None listed
Sponsors
Asklepios Neurological Clinic Bad Salzhausen
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Tracheal stenosis after percutaneous tracheotomy.
Exclusion criteria
* Pregnant or breast-feeding women of childbearing potential who refuse pregnancy test. * lack of consent to participate in the study. * surgical tracheotomy. * Involvement of the larynx (above the first tracheal brace).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Decannulation | 12 months | Rate of successful decannulations after intervention up to discharge from inpatient treatment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Technical success | 12 months | technical success of the intervention (endoscopically not clinically relevant tracheal stenosis). |
| Reintervention(s) | 12 months | Number of interventions required. |
| Type of intervention | 12 months | Type of intervention(s) (cyroablation, APC, loop extraction). |
| Clinical success | 12 months | Clinical success (no stridor, no dyspnoea). |
| Additional treatment | 12 months | Number of patients requiring surgical treatment/stent. |
Countries
Germany
Outcome results
None listed