BRIEF RESEARCH REPORT article
Front. Rehabil. Sci.
Sec. Pulmonary Rehabilitation
Volume 6 - 2025 | doi: 10.3389/fresc.2025.1598300
This article is part of the Research TopicRehabilitation of Mechanically Ventilated and Tracheostomized PatientsView all 3 articles
Plea for routine endoscopic tracheostomy tube adjustment
Provisionally accepted
- 1Neurological rehabilitation center Godeshöhe e. V., Bonn, Germany
- 2University Hospital Bonn, Bonn, Nordrhein-Westfalen, Germany
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Introduction: Tracheostomy is a standard procedure in intensive care medicine. In the context of tracheostomy tube-, dysphagia- anddecannulation management the selection of the appropriate tracheostomy tube model is crucial. Though recent guidelines mentionendoscopic control of the tube placement as a useful measure, data regarding the proper placement are rare in the present literature.Therefore, the aim of the present study was to investigate the accuracy of tube placement in patients admitted to our early neurologicalrehabilitation center. Methods: We performed a retrospective single-center analysis of patients with tracheostomy tube admitted between12/2022 and 01/2024. We analyzed the frequency, type and extent of injuries caused by a suboptimal tubeplacement. Tubelocation was routinely controlled endoscopically upon admission. In total 327 tracheoscopy results were divided into malpositioned (non-central tube position, often causing mucosal lesions, ulcer, bleeding) versus properly positioned tubes. The association between the quality of the tube placement and baseline characteristics, tracheostomy procedure and time until endoscopic control of tube fitting after tracheostomy were analyzed. Results: A total of 214 examinations (65%) revealed a malpositioned tube; in 19% manifest injuries were detected. No association between the quality of the tube position and gender, age, main diagnosis, time until initial endoscopic control of tube fitting or type of tracheostomy was found. Discussion: A high percentage of suboptimal tracheostomy tube positions was found, possibly causing delayed decannulation and an increased risk of early (ulcus) or late complications (tracheal stenosis). Therefore, the present data support a routine endoscopic control of tube placement.
Keywords: Tracheostomy tube adjustment, Tracheal cannula management, Tracheal lesion, Decannulation, Tracheoscopy
Received: 22 Mar 2025; Accepted: 08 Jul 2025.
Copyright: © 2025 Otto, Lindemann, Kirsch, Schmid, Vatter and Braun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bettina Otto, Neurological rehabilitation center Godeshöhe e. V., Bonn, Germany
Christiane Braun, Neurological rehabilitation center Godeshöhe e. V., Bonn, Germany
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