Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM, where
we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have peace of mind, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question last week was
My Dad Is Part of Medical Research in ICU, can it cause harm in life threatening
situations?
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“, I want to answer another frequently asked question from our readers and the question this week is
What are the chances of survival after a tracheostomy?
Many families in Intensive Care come to us and they have this very
question “What are the chances of survival after a tracheostomy?”
They often come to us with this very question when their loved one is on a ventilator with a breathing tube/endotracheal tube and can’t be weaned off the ventilator.
If their loved one can’t be weaned off the ventilator and potentially needs a tracheostomy wanting this question answered only makes sense.
Other crucial questions that also need to be answered when your loved one potentially needs a tracheostomy are the following (click on the links)
You might have heard me saying
this before on this blog and I say it again because it is so important to understand!
The most important goal for families in Intensive Care is to get their loved one off the ventilator and the breathing tube/endotracheal tube in the first place.
A tracheostomy has its time and its place but only after all efforts have been maximised to get your loved one off the ventilator and the breathing tube/endotracheal tube. This is also being referred to as extubation (removal of the breathing tube).
Here are some step by step instructions in how to get your loved one off the ventilator and the breathing tube/endotracheal tube (click on the link)
Now in case, you haven’t heard me mentioning it before, you also need to keep in mind that if a tracheostomy is the only valid option for your critically ill loved one in Intensive Care/ICU you need to keep in mind also that if you are in the United States, a
tracheostomy is often a vehicle to get your loved one out of ICU into LTAC (long-term acute care facility), often also being referred to as a long-term weaning ventilation facility.
Now I can only warn you that you should never agree to have your loved one go into LTAC in the first place because the only place where ventilated Patients can safely be looked after is Intensive Care/ICU or INTENSIVE CARE AT HOME.
Why? Because in order to manage ventilation, tracheostomy and the weaning process you need ICU doctors and ICU nurses.
LTAC’s are a disaster and many Patients die in LTAC, that’s the unfortunate
reality.
A discharge into LTAC is also often happening prematurely in order to empty ICU beds without considering the clinical needs, because ICU beds are in high demand.
I have more information here why you should avoid LTAC at all cost
Now that you have a good understanding about the territory of ventilation, breathing tube/endotracheal tube and tracheostomy now it’s time to look at our original
question
What are the chances of survival after a tracheostomy?
Here are some numbers and statistics from this website here
https://www.ncbi.nlm.nih.gov/pubmed/14718444
Hospital and long-term outcome after tracheostomy for respiratory failure
RESULTS:
Four hundred twenty-nine patients were studied. Hospital mortality was 19%. Only 57% of survivors were liberated from mechanical ventilation. At 100 days, 6 months, 1 year,
and 2 years after discharge, 24%, 30%, 36%, and 42% of hospital survivors had died, respectively. Patients liberated from mechanical ventilation and having their tracheostomy tubes decannulated had the lowest mortality (8% at 1 year); the mortality of ventilator-dependent patients was highest (57%). Sixty-six patients completed the SF-36 for functional status. While emotional health was generally good, physical function was quite limited.
Here
is also a link to another study which suggests fairly similar results and outcomes for Patients with tracheostomy after respiratory failure
https://pdfs.semanticscholar.org/cd26/a70d335cfcc95c1cbcf436d1fe00cba7afd3.pdf
Now, what does that actually mean? Let me explain and break it down for you.
If 57% of survivors were liberated from mechanical ventilation it doesn’t actually say what happened to the tracheostomy.
What do I mean by
that?
Many Patients might actually be liberated from mechanical ventilation and yet they still need the tracheostomy. Why do they still need the tracheostomy?
They need the tracheostomy for secretion management, swallowing difficulties and therefore aspiration Pneumonia risk and many other issues.
Again, here is more information regarding tracheostomy and if it can be reversed
Also, if a tracheostomy can’t be reversed and you or your loved one want to go home, the best next step is to engage a service like INTENSIVE CARE AT HOME so the tracheostomy can be safely managed at home and keep you or your loved one out of hospital
Next, if some Patients on a ventilator and tracheostomy are unable to be weaned off mechanical ventilation and the tracheostomy or if
they take a lot longer than anticipated, rather than staying in Intensive Care/ICU long-term or even worse going to LTAC (long-term acute care facility), the best option for long-term ventilation with tracheostomy is for your loved one to go home with a service like INTENSIVE CARE AT HOME.
INTENSIVE CARE AT HOME brings Intensive Care skills, including ventilator and tracheostomy competent nurses into the comfort of your own home 24/7.
This creates a win-win situation
- It improves the quality of life for your loved one and for you as a family. Finally you and your loved one can go home and relax, because you have the professionals where you need
them
- It frees up bed capacity in Intensive Care/ICU
- It reduces the cost of an Intensive Care/ICU bed by 50%
- Either long-term mechanical ventilation with tracheostomy at home is possible
- Ventilation weaning at home is
possible
The list of the advantages of going home with INTENSIVE CARE AT HOME is incomplete but you get the idea!
Everybody is winning with INTENSIVE CARE AT HOME.
Recommended:
Next, some Patients on ventilation with tracheostomy during prolonged mechanical ventilation approach their end of life unfortunately.
But rather than prematurely withdrawing treatment or “pulling the plug”, you still want your loved one to live!
Therefore, you and your family can also use a professional service like INTENSIVE CARE AT HOME for end of life care and palliative care at home rather than end of life care in a sterile hospital environment!
Did you know that 75% of the population in
developed countries want to die at home and yet only 14% actually do die at home?
INTENSIVE CARE AT HOME enables long-term ventilated Patients with tracheostomy to approach their end of life at home!
Again this achieves the following advantages and creates a win-win situation
- It improves the quality of end of life for your loved one
and for you as a family. Finally you and your loved one can go home and relax, because you have the professionals where you need them
- It frees up bed capacity in Intensive Care/ICU
- It reduces the cost of an Intensive Care/ICU bed by 50%
- It creates peace and harmony when you need it the most in the comfort of your
own home!
The list of the advantages of going home with INTENSIVE CARE AT HOME is incomplete but you get the idea!
INTENSIVE CARE AT HOME services are available for both adults& children and you can see the full list of service offerings here
Kind Regards
Patrik
