{"id":8,"date":"2020-09-30T10:45:10","date_gmt":"2020-09-30T10:45:10","guid":{"rendered":"https:\/\/www.drjaimeclavijo.com\/v2.1\/services\/"},"modified":"2020-10-31T13:39:19","modified_gmt":"2020-10-31T13:39:19","slug":"procedures","status":"publish","type":"page","link":"https:\/\/www.drjaimeclavijo.com\/v2.1\/procedures\/","title":{"rendered":"Processes"},"content":{"rendered":"\t\t
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What Is Bronchoscopy?<\/strong><\/p>\n

Bronchoscopy (bron-KOS-ko-pee) is a procedure that allows your doctor to look inside your lungs’ airways, called the bronchi (BRONG-ki) and bronchioles (BRONG-ke-ols). The airways carry air from the trachea (TRA-ke-ah), or windpipe, to the lungs.
During the procedure, your doctor inserts a thin, flexible tube called a bronchoscope into your nose or mouth. The tube is passed down your throat into your airways. If you have a breathing tube, the bronchoscope can be passed through the tube to your airways. You’ll be given medicine to make you relaxed and sleepy during the procedure.
The bronchoscope has a light and small camera that allow your doctor to see your windpipe and airways and take pictures.
If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.
A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia (AN-es-THE-ze-ah). The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.
Overview<\/strong>
Bronchoscopy can help find the cause of a lung problem. For example, during the procedure, your doctor may see:
\u2022A tumor
\u2022Signs of infection
\u2022Excess mucus in the airways
\u2022The site of bleeding
\u2022A blockage (such as a piece of food) in your airway
Your doctor also may take samples of mucus or tissue from your lungs to test in a laboratory.
Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be done to insert a stent in an airway. An airway stent is a small tube that holds the airway open. It might be used if a tumor or other condition blocks the airway.
In children, bronchoscopy most often is used to remove an object blocking an airway. Sometimes it’s used to find out what’s causing a cough that has lasted for at least a few weeks.
Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.
Newer types of bronchoscopy include:
\u2022Endobronchial (EN-do-BRONG-ke-al) ultrasound. This procedure uses sound waves to create pictures of the insides your airways.
\u2022Fluorescence (flor-ES-ents) bronchoscopy. This procedure uses fluorescent light instead of white light to look inside your airways.
\u2022Virtual bronchoscopy. This procedure uses a new method of computed tomography (to-MOG-rah-fee) scan, or CT scan. Virtual bronchoscopy can create detailed pictures of your airways.
Outlook<\/strong>
Bronchoscopy is a safe procedure. Side effects and complications usually are minor. You may feel hoarse and have a sore throat after the procedure. Minor bleeding, infection, and fever also can occur.
A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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Who Needs Bronchoscopy?<\/strong>
Your doctor may recommend bronchoscopy if you have an abnormal chest x ray or chest CT scan. These tests may show a tumor, a pneumothorax (collapsed lung), or signs of an infection.

A chest x ray creates a picture of the structures in your chest, such as your heart and lungs. A chest CT scan uses special x rays to create detailed pictures of the structures in your chest.

Other reasons for needing bronchoscopy include coughing up blood or having a cough that lasts more than a few weeks.

Sometimes doctors use bronchoscopy to treat lung problems. For example, the procedure might be used to:
\u2022Remove something that’s stuck in an airway (like a piece of food).
\u2022Place medicine in a lung to treat a lung problem.
\u2022Insert a stent (small tube) in an airway to hold it open. A stent might be used if a tumor or other condition blocks an airway.

Doctors also can use bronchoscopy to check for swelling in the upper airways and vocal cords of people who were burned around the throat area or who inhaled smoke from a fire.

In children, the procedure most often is used to remove an object blocking an airway.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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What To Expect Before Bronchoscopy<\/strong>Bronchoscopy is done in a hospital or special clinic. To prepare for the procedure, tell your doctor:
\u2022What medicines you’re taking, including prescription and over-the-counter medicines. It’s helpful to give your doctor a list of your medicines.
\u2022Whether you’ve had any bleeding problems.
\u2022Whether you have any allergies to medicines or latex.

You’ll be given medicine before the procedure to help you relax. The medicine will make you sleepy, so you should arrange for a ride home after the procedure.

You’ll have to fast (not eat or drink anything) for 6\u201312 hours before the procedure. Your doctor will let you know the exact amount of time you should fast.<\/p>\n

Source:National Heart Lung and Blood Institute<\/a><\/p>\n

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What To Expect During Bronchoscopy<\/strong><\/p>\n

Your doctor will do the bronchoscopy in an exam room at a hospital or special clinic. The procedure usually lasts about 30 minutes. But the entire process, including preparation and recovery time, takes about 4 hours.

Your doctor will give you medicine through an intravenous (IV) line in your bloodstream or by mouth. The medicine will make you relaxed and sleepy.\u00a0
<
Your doctor also will squirt or spray a liquid medicine into your nose and throat to numb them. This helps prevent coughing and gagging when the bronchoscope (long, thin tube) is inserted.

Next, your doctor will insert the bronchoscope through your nose or mouth, down your throat, and into your airways. As the tube enters your mouth, you may gag a little. Once it enters your throat, that feeling will go away.

Your doctor will look at your vocal cords and airways through the bronchoscope (which has a light and a small camera).

The animation below shows a bronchoscopy procedure. Click the “start” button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.<\/p>\n

VIDEO<\/a><\/p>\n

The animation shows how a doctor inserts a bronchoscope into a patient’s nose and passes it down into the airways. This allows the doctor to look inside the airways.

During the procedure, your doctor may take a sample of lung fluid or tissue for further testing. Samples can be taken using:
\u2022Bronchoalveolar lavage (BRON-ko-al-VE-o-lar la-VAHZH). For this method, your doctor passes a small amount of saline solution (salt water) through the bronchoscope and into part of your lung. He or she then suctions the salt water back out. The fluid picks up cells and bacteria from the airway, which your doctor can study.
\u2022Transbronchial lung biopsy. For this method, your doctor inserts forceps into the bronchoscope and takes a small tissue sample from inside the lung.
\u2022Transbronchial needle aspiration. For this method, your doctor inserts a needle into the bronchoscope and removes cells from the lymph nodes in your lungs. These nodes are small, bean-shaped masses. They trap bacteria and cancer cells and help fight infections.

You may feel short of breath during bronchoscopy, but enough air is getting to your lungs. Your doctor will check your oxygen level. If the level drops, you’ll be given oxygen.

If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects.

A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia. The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep.

After the procedure is done, your doctor will remove the bronchoscope.

Newer Types of Bronchoscopy
<\/strong>
Researchers are studying new types of flexible bronchoscopy. They might make it easier to detect tumors and other lung problems, especially in the lungs’ small airways. These procedures also might make it easier to take fluid and tissue samples from your lungs.

<\/strong>Endobronchial Ultrasound
<\/strong>
This procedure is done the same way as a standard flexible bronchoscopy. However, an ultrasound probe is attached to the end of the flexible tube. The probe uses sound waves to create pictures of your lungs. Your doctor can see these pictures on a computer screen.

Fluorescence Bronchoscopy
<\/strong>
This procedure also is done the same way as a standard flexible bronchoscopy. However, a fluorescent light is attached to the bronchoscope instead of a white light. Under fluorescent light, tiny tumors look dark red, and healthy tissue looks green.

During the test, your doctor can remove cells from the lymph nodes in your lungs for testing.

Virtual Bronchoscopy
<\/strong>
This procedure uses a new method of computed tomography (CT) scan to look inside your lungs. Virtual bronchoscopy uses special x rays to create detailed pictures of your lungs’ airways. A bronchoscope is not used for this procedure.

During the scan, you lie on a table that slides through the center of a tunnel-shaped x-ray machine. X-ray tubes in the scanner rotate around you and take pictures of your lungs and airways.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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What To Expect After Bronchoscopy
<\/strong>
After bronchoscopy, you’ll need to stay at the hospital or clinic for up to a few hours. If your doctor uses a bronchoscope with a rigid tube, the recovery time is longer. While you’re at the clinic or hospital:
\u2022You may have a chest x ray if your doctor took a sample of lung tissue. This test will check for a pneumothorax and bleeding. A pneumothorax is a condition in which air collects in the space around the lungs. This can cause one or both lungs to collapse.
\u2022A nurse will check your breathing and blood pressure.
\u2022You can’t eat or drink until the numbness in your throat wears off, which will take about 1\u20132 hours.

After recovery, you’ll need someone to drive you home because you’ll be too sleepy to drive.

If samples of tissue or fluid were taken during the procedure, they’ll be tested in a laboratory (lab). Talk to your doctor about when you’ll get the lab results.

Recovery and Recuperation
<\/strong>
Your doctor will let you know when you can return to your normal activities, such as driving, working, and physical activity.

For the first few days, you may have a sore throat, cough, and hoarseness. Call your doctor right away if you:
\u2022Develop a fever
\u2022Have chest pain
\u2022Have trouble breathing
\u2022Cough up more than a few tablespoons of blood<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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What Does Bronchoscopy Show?
<\/strong>
During bronchoscopy, your doctor may see a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or a blockage in your airway.

Endobronchial ultrasound can show enlarged lymph nodes and tumors in and near the airways. Enlarged lymph nodes can suggest an infection or other problem. The procedure also is used to determine the extent of lung cancer.

Fluorescence bronchoscopy can show an abnormal lesion that can’t be seen with standard flexible bronchoscopy. Some lesions may become cancerous. When lesions are detected early, they may be easier to treat.

Virtual bronchoscopy can show lung problems in the tiny branches of the airways and outside of the airways.

Your doctor will use the results of your bronchoscopy to decide how to treat any lung problems that were found. He or she may recommend other tests or procedures.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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What Are the Risks of Bronchoscopy?<\/strong><\/p>\n

Bronchoscopy is a safe procedure, and complications usually are minor. They might include:
\u2022A drop in your oxygen level during the procedure. Your doctor will give you oxygen if this happens.
\u2022Minor bleeding, infection, and fever.

A rare, but more serious risk is a pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse.

A small pneumothorax might go away on its own. However, if it interferes with breathing, your doctor may use a chest tube to remove the air.

After bronchoscopy, your doctor may suggest that you have a chest x ray to check for complications.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\n

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Clinical Trials<\/strong><\/p>\n

The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.

NHLBI-supported research has led to many advances in medical knowledge and care. For example, this research has helped look for better ways to diagnose and evaluate lung problems using procedures such as bronchoscopy.

The NHLBI continues to support research on bronchoscopy. For example, the NHLBI currently sponsors a study to explore how bronchoscopy can help improve the understanding of inflamed airways and asthma.

Much of the NHLBI’s research depends on the willingness of volunteers to take part in clinical trials. Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions.

For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.

By taking part in a clinical trial, you may gain access to new treatments before they’re widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don’t directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.

If you volunteer for a clinical trial, the research will be explained to you in detail. You’ll learn about treatments and tests you may receive, and the benefits and risks they may pose. You’ll also be given a chance to ask questions about the research. This process is called informed consent.

If you agree to take part in the trial, you’ll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.

For more information about clinical trials related to bronchoscopy, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:
\u2022http:\/\/clinicalresearch.nih.gov
\u2022www.clinicaltrials.gov
\u2022www.nhlbi.nih.gov\/studies\/index.htm
\u2022www.researchmatch.org

For more information about clinical trials for children, visit the NHLBI’s Children and Clinical Studies Web page.<\/p>\n

Source: National Heart Lung and Blood Institute<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Spirometry<\/strong><\/p>\n

<\/span>Spirometry measures how much air you breathe in and out and how fast you blow it out. This is measured two ways: peak expiratory flow rate (PEFR) and forced expiratory volume in 1 second (FEV1).<\/span><\/span>
PEFR is the fastest rate at which you can blow air out of your lungs. FEV1 refers to the amount of air you can blow out in 1 second.<\/span>
During the test, a technician will ask you to take a deep breath in. Then, you’ll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer.<\/span>
IMAGE<\/a>
The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.
Your doctor may have you inhale a medicine that helps open your airways. He or she will want to see whether the medicine changes or improves the test results.
Spirometry helps check for conditions that affect how much air you can breathe in, such as pulmonary fibrosis (scarring of the lung tissue). The test also helps detect diseases that affect how fast you can breathe air out, like asthma and COPD (chronic obstructive pulmonary disease).<\/span><\/p>\n

Tests To Measure Oxygen Level<\/strong><\/p>\n

Pulse oximetry and arterial blood gas tests show how much oxygen is in your blood. During pulse oximetry, a small sensor is attached to your finger or ear. The sensor uses light to estimate how much oxygen is in your blood. This test is painless and no needles are used.For an arterial blood gas test, a blood sample is taken from an artery, usually in your wrist. The sample is sent to a laboratory, where its oxygen level is measured. You may feel some discomfort during an arterial blood gas test because a needle is used to take the blood sample.<\/p>\n

Testing in Infants and Young Children<\/strong><\/p>\n

Spirometry and other measures of lung function usually can be done for children older than 6 years, if they can follow directions well. Spirometry might be tried in children as young as 5 years. <\/span>However, technicians who have special training with young children may need to do the testing.
<\/span>Instead of spirometry, a growing number of medical centers measure respiratory system resistance. This is another way to test lung function in young children.
<\/span>The child wears nose clips and has his or her cheeks supported with an adult’s hands. The child breathes in and out quietly on a mouthpiece, while the technician measures changes in pressure at the mouth. During these lung function tests, parents can help comfort their children and encourage them to cooperate.
<\/span>Very young children (younger than 2 years) may need an infant lung function test. This requires special equipment and medical staff. This type of test is available only at a few medical centers.
<\/span>The doctor gives the child medicine to help him or her sleep through the test. A technician places a mask over the child’s nose and mouth and a vest around the child’s chest.
<\/span>The mask and vest are attached to a lung function machine. The machine gently pushes air into the child’s lungs through the mask. As the child exhales, the vest slightly squeezes his or her chest. <\/span>This helps push more air out of the lungs. The exhaled air is then measured.
<\/span>In children younger than 5 years, doctors likely will use signs and symptoms, medical history, and a physical exam to diagnose lung problems.
<\/span>Doctors can use pulse oximetry and arterial blood gas tests for children of all ages.<\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\n

\u00a0<\/p>\n

What To Expect Before Lung Function Tests<\/strong><\/p>\n

If you take breathing medicines, your doctor may ask you to stop them for a short time before spirometry, lung volume measurement, or lung diffusion capacity tests.
No special preparation is needed before pulse oximetry and arterial blood gas tests. If you’re getting oxygen therapy, your doctor may ask you to stop using it for a short time before the tests. This allows your doctor to check your blood oxygen level without the added oxygen.<\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\n

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What To Expect During Lung Function Tests<\/strong>Breathing Tests<\/strong><\/p>\n

Spirometry might be done in your doctor’s office or in a special lung function laboratory (lab). Lung volume measurement and lung diffusion capacity tests are done in a special lab or clinic. For these tests, you sit in a chair next to a machine that measures your breathing. For spirometry, you sit or stand next to the machine.
Before the tests, a technician places soft clips on your nose. This allows you to breathe only through a tube that’s attached to the testing machine. The technician will tell you how to breathe into the tube. For example, you might be asked to breathe normally, slowly, or rapidly.
Some tests require deep breathing, which might make you feel short of breath, dizzy, or light-headed, or it might make you cough.<\/span><\/p>\n

Spirometry<\/strong><\/p>\n

For this test, you take a deep breath and then exhale as fast and as hard as you can into the tube. With spirometry, your doctor may give you medicine to help open your airways. Your doctor will want to see whether the medicine changes or improves the test results.<\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\n

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What Do Lung Function Tests Show?<\/strong>Breathing Tests<\/strong>
Spirometry<\/strong>Spirometry can show whether you have:
\u2022A blockage (obstruction) in your airways. This may be a sign of asthma, COPD (chronic obstructive pulmonary disease), or another obstructive lung disorder.
\u2022Smaller than normal lungs (restriction). This may be a sign of heart failure, pulmonary fibrosis (scarring of the lung tissue), or another restrictive lung disorder.<\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\n

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What Are the Risks of Lung Function Tests?<\/strong><\/p>\n

Spirometry, lung volume measurement tests, and lung diffusion capacity tests usually are safe. These tests rarely cause problems.
Pulse oximetry has no risks. Side effects from arterial blood gas tests are rare.<\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Tracheostomy<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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What Is a Tracheostomy?
<\/strong>A tracheostomy (TRA-ke-OS-to-me) is a surgically made hole that goes through the front of your neck and into your trachea (TRA-ke-ah), or windpipe. The hole is made to help you breathe.
<\/span>A tracheostomy usually is temporary, although you can have one long term or even permanently. How long you have a tracheostomy depends on the condition that required you to get it and your overall health.
<\/span>Overview<\/strong>
To understand how a tracheostomy works, it helps to understand how your airways work. The airways carry oxygen-rich air to your lungs. They also carry carbon dioxide, a waste gas, out of your lungs.
<\/span>The airways include your:
<\/span>\u2022Nose and linked air passages (called nasal cavities)
<\/span>\u2022Mouth
<\/span>\u2022Larynx (LAR-ingks), or voice box
<\/span>\u2022Trachea, or windpipe
<\/span>\u2022Tubes called bronchial tubes or bronchi, and their branches
<\/span>Air enters your body through your nose or mouth. The air travels through your voice box and down your windpipe. The windpipe splits into two bronchi that enter your lungs. (For more information, go to the Health Topics How the Lungs Work article.)
<\/span>A tracheostomy provides another way for oxygen-rich air to reach your lungs, besides going through your nose or mouth. A breathing tube, also called a trach (trake) tube, is put through the tracheostomy and directly into the windpipe to help you breathe.
<\/span>Doctors use tracheostomies for many reasons. One common reason is to help people who need to be on ventilators (VEN-til-a-tors) for more than a couple of weeks.
<\/span>Ventilators are machines that support breathing. If you have a tracheostomy, the trach tube connects to the ventilator.
<\/span>People who have conditions that interfere with coughing or block the upper airways also may need tracheostomies. Coughing is a natural reflex that protects the lungs. It helps clear mucus (a slimy substance) and bacteria from the airways. A trach tube can be used to help remove, or suction, mucus from the airways.
<\/span>Doctors also might recommend tracheostomies for people who have swallowing problems due to strokes or other conditions.
<\/span>Outlook<\/strong>
Creating a tracheostomy is a fairly common, simple procedure. It’s one of the most common procedures for critical care patients in hospitals.
<\/span>The windpipe is located almost directly under the skin of the neck. So, a surgeon often can create a tracheostomy quickly and easily.
<\/span>The procedure usually is done in a hospital operating room. However, it also can be safely done at a patient’s bedside. Less often, a doctor or emergency medical technician may do the procedure in a life-threatening situation, such as at the scene of an accident or other emergency.
<\/span>As with any surgery, complications can occur, such as bleeding, infection, and other serious problems. The risks often can be reduced with proper care and handling of the tracheostomy and the tubes and other related supplies.
<\/span>Some people continue to need tracheostomies even after they leave the hospital. Hospital staff will teach patients and their families or caregivers how to properly care for their tracheostomies at home.<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute
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Other Names for a Tracheostomy<\/strong>
\u2022Trach
<\/span>\u2022Stoma<\/span><\/span><\/p>\n

Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/p>\n

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Who Needs a Tracheostomy?
<\/strong>People of all ages may need tracheostomies for various reasons.
<\/span><\/span>People Who Are on Ventilators.<\/strong>
<\/span><\/span>A common reason for needing a tracheostomy is the use of a ventilator (VEN-til-a-tor) for more than a couple of weeks.
<\/span><\/span>A ventilator is a machine that supports breathing. It’s connected to a tube that is put through the tracheostomy. This tube often is called a trach tube. The tube carries oxygen-rich air from the ventilator to the lungs.
<\/span><\/span>For people who are on ventilators and awake, a trach tube might be more comfortable than a breathing tube put through the nose or mouth and down into the windpipe. A trach tube also makes it possible for some people who are on ventilators to eat and talk.
<\/span><\/span>Depending on your reason for needing a ventilator, your tracheostomy might be temporary or permanent. If you need a ventilator for the rest of your life, your tracheostomy will likely be permanent.
<\/span><\/span>If your doctor decides that you can stop using the ventilator, you may no longer need the tracheostomy. You can then let the hole close up, either on its own or with surgery.
<\/span><\/span>People Who Have Conditions That Affect Coughing or Block the Airways<\/strong>
<\/span><\/span>Your doctor might recommend a tracheostomy if you have trouble coughing. Coughing is a natural reflex that protects your lungs. It helps clear mucus and bacteria from your airways. If you have trouble coughing, a trach tube can help suction mucus from your airways.
<\/span><\/span>Your doctor also might recommend a tracheostomy if you have a condition that obstructs, or blocks, your upper airways. Examples of diseases, conditions, and other factors that might interfere with coughing or block your upper airways include:
<\/span><\/span>\u2022Congenital defects of the upper airways (in children). “Congenital” means that the defects are present at birth.
<\/span><\/span>\u2022Airway injuries from smoke, steam, or chemical burns.
<\/span><\/span>\u2022Severe allergic reactions or infections.
<\/span><\/span>\u2022Removal of the larynx (for example, from cancer).
<\/span><\/span>\u2022Long-term coma.
<\/span><\/span>\u2022Neuromuscular diseases that paralyze or weaken the muscles and nerves involved in breathing.
<\/span><\/span>\u2022Spinal cord injuries.
<\/span><\/span>Some of these conditions are temporary. Once you recover enough to breathe easily and safely on your own, you may no longer need the tracheostomy. Other conditions may require you to have a tracheostomy long term or even permanently.
<\/span><\/span>People Who Have Swallowing Problems<\/strong>
<\/span><\/span>Your doctor may recommend a tracheostomy if you have trouble swallowing due to a stroke or other condition. You may need the tracheostomy until you can swallow normally again.<\/span><\/span><\/span><\/p>\n

<\/span><\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n


<\/a>What To Expect Before a Tracheostomy<\/strong>
The procedure to make a tracheostomy usually is done in a hospital operating room. However, it also can be safely done at a patient’s bedside.
<\/span>Rarely, a doctor or emergency medical technician will do the procedure in a life-threatening situation, such as at the scene of an accident or other emergency.
<\/span>When the procedure is done in a hospital, a general or pediatric surgeon or an otolaryngologist does the surgery. Otolaryngologists specialize in diagnosing and treating problems with the ears, nose, and throat and related structures of the head. These doctors also are called ear, nose, and throat (ENT) doctors.
<\/span>A pulmonologist or intensive care doctor may help assess your need for a tracheostomy. A pulmonologist specializes in diagnosing and treating lung diseases and conditions.
<\/span>Often, doctors have to create tracheostomies on short notice, so you have little time to prepare. When possible, the surgical team may request that you fast (not eat anything) for 6\u20138 hours before the surgery.
<\/span>If you’re having a tracheostomy procedure, you’ll receive general or local anesthesia (AN-es-THE-ze-ah). The term “anesthesia” refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep. Local anesthesia numbs the neck and surrounding area.<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n


<\/a>What To Expect During a Tracheostomy
<\/strong>To create a tracheostomy, your surgeon will make a cut through the lower front part of your neck. He or she will then make a cut in your trachea, or windpipe.
<\/span>The surgeon will place a tube (called a trach tube) through the hole and into the windpipe. The tube will help keep the hole open. Some trach tubes are “cuffed.” Doctors can widen or narrow cuffed tubes by inflating or deflating them with air.
<\/span>You may have a chest x ray to ensure the trach tube is placed correctly. The tube will then be held in place with stitches, surgical tape, or a Velcro band.
<\/span>The procedure to make a tracheostomy usually takes between 20 and 45 minutes.
<\/span> <\/strong><\/span><\/p>\n

Tracheostomy
<\/strong>IMAGE
<\/a><\/span>Figure A shows a side view of the neck and the correct placement of a trach tube in the trachea, or windpipe. Figure B shows an external view of a patient who has a tracheostomy.<\/span>
<\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n


<\/a>What To Expect After a Tracheostomy<\/strong>
Depending on your overall health, you may stay in the hospital for 3\u201310 days or more after getting a tracheostomy. It can take up to 2 weeks for a tracheostomy to fully form, or mature.
<\/span>You might be sedated during your recovery. This means that you’ll be given medicine to help you relax. The medicine might make you sleepy.
<\/span>Eating<\/strong>
Until the tracheostomy is mature, you won’t be able to eat normally. Instead of food, you may receive nutrients through an intravenous (IV) line inserted into a vein in your body. Or, you may get food through a feeding tube.
<\/span>The feeding tube is placed through your nose or mouth and guided to your stomach. If you’ll be on a ventilator for a long time, the tube might be placed directly into your stomach or small intestine through a surgically made hole.
<\/span>After the tracheostomy has matured, you’ll likely work with a speech therapist to regain your ability to swallow normally. You may have swallowing tests to show whether you can swallow safely. If you can, you might be able to start eating normally again.
<\/span>Communicating<\/strong>
You won’t be able to talk right after the procedure. Even after the tracheostomy has matured, you’ll still have trouble speaking. The trach tube interferes with the normal voice process. It prevents air from the lungs from flowing over the voice box.
<\/span>However, once your tracheostomy has matured, a speech therapist or other health professional will show you ways in which you can use your voice to speak clearly.
<\/span>One option is a speaking valve that attaches to the trach tube. The valve lets air enter the tracheostomy, pass into the windpipe and up over the voice box, and then exit the mouth or nose.
<\/span>Certain types of cuffed trach tubes also can help you speak. Doctors can widen or narrow cuffed tubes by inflating or deflating the cuffed part with air.
<\/span>If you’re using a ventilator, for example, the cuffed tube is inflated to fill the width of the airway. If you aren’t using a ventilator, the tube can be deflated. This allows some air to enter the windpipe and pass over the voice box.
<\/span>Other Concerns<\/strong>
If you no longer need the tracheostomy, your doctor will remove your trach tube. The hole should close up on its own fairly quickly.
<\/span>If the hole doesn’t close on its own, you may need surgery to close it. A small scar will remain at the site of the tracheostomy.<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n

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What Are the Risks of a Tracheostomy?
<\/strong>As with any surgery, a tracheostomy procedure can cause complications. Some complications are more likely to occur soon after the procedure is done. Others are more likely to happen over time.
<\/span>Some complications are related to the tube that is put through the tracheostomy into the windpipe (the trach tube).
<\/span>Proper care and handling of the tracheostomy and the tubes and other related supplies can help reduce risks.
<\/span>Immediate Complications<\/strong>
Complications that can occur shortly after surgery include:
<\/span>\u2022Bleeding and infection.
<\/span>\u2022Pneumothorax (noo-mo-THOR-aks). This is a condition in which air or gas builds up in the space between the lungs and chest wall. Pneumothorax can cause sudden pain in one side of the lung and shortness of breath. The condition also can put pressure on the lung and cause it to collapse.
<\/span>\u2022Subcutaneous emphysema (sub-ku-TA-ne-us em-fi-SE-ma). This is a condition in which air gets trapped beneath the skin.
<\/span>Later Complications<\/strong>
Over time, other complications can develop. For example, infections may scar the windpipe. A fistula (FIS-tu-lah), or abnormal connection, may form between the windpipe and esophagus. (The esophagus is the passage leading from your mouth to your stomach.)
<\/span>A fistula between the windpipe and esophagus can cause food and saliva to enter the lungs and possibly cause pneumonia. Symptoms of a fistula include severe coughing and trouble breathing.
<\/span>Trach Tube Complications<\/strong>
Some complications are related to the trach tube. For example, the tube may slip or fall out of the tracheostomy. Other problems include:
<\/span>\u2022Abnormal tissue masses, or granulations (GRAN-u-LA-shuns), in the airways
<\/span>\u2022Narrowing or collapse of the airway above the trach tube’s location
<\/span>\u2022Irritation of the windpipe’s inside lining from the tube rubbing against the lining’s surface
<\/span>\u2022Blockage of the tracheostomy from dried secretions and mucus masses (also called plugs)
<\/span>\u2022Infection
<\/span>\u2022Failure of the tracheostomy to close on its own after the trach tube is removed<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n

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Living with a Tracheostomy<\/strong>
You may still need a tracheostomy after you leave the hospital. If so, hospital staff will show you and your family or caregiver how to care for the tracheostomy at home.
<\/span>Proper care and handling of the tracheostomy and the tubes and other related supplies can help reduce the risk of complications, such as infection.
<\/span>You’ll learn how to clean the tracheostomy site, change your trach tube, suction your airways using the trach tube, and work with a home care service.
<\/span>Home care services allow people who have special needs to stay in their homes. Home care services may provide medical equipment, visits from health care professionals, and help giving medicines. This service also may help with routine care of your tracheostomy.
<\/span>Before you leave the hospital, you’ll also learn about signs and symptoms of possible complications. Your doctor will let you know when you should call him or her and when to seek emergency care.
<\/span>After you leave the hospital, you’ll need ongoing care with your doctor. This will allow your doctor to monitor your health and check for possible problems.<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n

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Clinical Trials
<\/strong>The National Heart, Lung, and Blood Institute (NHLBI) is strongly committed to supporting research aimed at preventing and treating heart, lung, and blood diseases and conditions and sleep disorders.
<\/span>NHLBI-supported research has led to many advances in medical knowledge and care. Often, these advances depend on the willingness of volunteers to take part in clinical trials.
<\/span>Clinical trials test new ways to prevent, diagnose, or treat various diseases and conditions. For example, new treatments for a disease or condition (such as medicines, medical devices, surgeries, or procedures) are tested in volunteers who have the illness. Testing shows whether a treatment is safe and effective in humans before it is made available for widespread use.
<\/span>By taking part in a clinical trial, you can gain access to new treatments before they’re widely available. You also will have the support of a team of health care providers, who will likely monitor your health closely. Even if you don’t directly benefit from the results of a clinical trial, the information gathered can help others and add to scientific knowledge.
<\/span>If you volunteer for a clinical trial, the research will be explained to you in detail. You’ll learn about treatments and tests you may receive, and the benefits and risks they may pose. You’ll also be given a chance to ask questions about the research. This process is called informed consent.
<\/span>If you agree to take part in the trial, you’ll be asked to sign an informed consent form. This form is not a contract. You have the right to withdraw from a study at any time, for any reason. Also, you have the right to learn about new risks or findings that emerge during the trial.
<\/span>For more information about clinical trials related to tracheostomies, talk with your doctor. You also can visit the following Web sites to learn more about clinical research and to search for clinical trials:
<\/span>\u2022http:\/\/clinicalresearch.nih.gov
<\/span>\u2022www.clinicaltrials.gov
<\/span>\u2022www.nhlbi.nih.gov\/studies\/index.htm
<\/span>\u2022www.researchmatch.org
<\/span>For more information about clinical trials for children, visit the NHLBI’s Children and Clinical Studies Web page.<\/span><\/span><\/p>\n

<\/span>Source: N<\/span>ational Heart Lung and Blood Institute<\/a><\/span><\/p>\n<\/address>\n

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Sleep Studies<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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What Are Sleep Studies?<\/strong><\/p>\n

Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is.<\/p>\n

Sleep studies are important because untreated sleep disorders can raise your risk for heart disease, high blood pressure, stroke, and other medical conditions. Sleep disorders also have been linked to an increased risk of injury, such as falling (in the elderly) and car accidents.<\/p>\n

People usually aren’t aware of their breathing and movements while sleeping. They may never think to talk to their doctors about issues that might be related to sleep problems.<\/p>\n

However, sleep disorders can be treated. Talk with your doctor if you snore regularly or feel very tired while at work or school most days of the week.<\/p>\n

You also may want to talk with your doctor if you often have trouble falling or staying asleep, or if you wake up too early and aren’t able to go back to sleep. These are common signs of a sleep disorder.<\/p>\n

Your doctor might be able to diagnose a sleep disorder based on your sleep schedule and habits. However, he or she also might need the results from sleep studies and other medical tests to diagnose a sleep disorder.<\/p>\n

Sleep studies can help diagnose:<\/p>\n