Are frequent inner cannula changes necessary?: A pilot study☆

Abstract 

OBJECTIVE: To determine the incidence of obstruction and colonization in adult patients in the surgical and medical intensive care units who received inner cannula changes daily versus those who did not.

DESIGN: Quasi-experimental prospective study using a convenience sample of patients randomly assigned to one of two methods.

SETTING: Mid-Atlantic university-affiliated tertiary care center.

PATIENTS: Sixty patients within 24 hours of receiving a surgical tracheostomy.

OUTCOME MEASURES: Obstruction and bacterial colonization of inner cannula.

INTERVENTIONS: All inner cannulas were checked daily for obstruction and cultured on postoperative days 1 and 3.

RESULTS: No statistically significant difference was noted in colonization (p = 0.13) between protocols, and no obstructions were noted in either.

CONCLUSION: The study suggests that the routine practice in critical care units of changing tracheostomy inner cannulas may be unnecessary. Although the results of this study are limited, and may not be generalized to other populations, it demonstrates that practice standards related to the care of tracheostomy inner cannula need to be challenged.

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