granulation tissue question?

babysupermansmommy · #1 10-07-2008, 01:26 PM

when i suction anthony i go down to 12 unless deep suctioning and i useally hit bottom at 16-17. The past couple days i have been noticing when he needs deep suctioning that it hits at about 14-15 but then sometimes it will go on threw to 16-17. is it possible that he has granulation tissue after his trach tube ends? i have seen no blood and he does not seem to be coughing and all his vent numbers are perfect! Am I over reacting? his oxygen is also at 100 percent at all times.

he has been throwing up some high pressures on the vent from time to time during the day. what does that useally mean, i forgot, i feel so bad but i have been running around with my head cut off recently! hes on a newport ht50

any suggestions?

saywhatyouwill · #2 10-07-2008, 01:47 PM

i don't have a suggestion as such, but we were told lots of times by the ENT drs to never deep suction because it can result in scarring and granulation tissue which can affect future success of surgery.

so we never ever go past the end of the tube (at 5).

twintotwin · #3 10-07-2008, 02:55 PM

I've always cringed at deep sx'ing when our RT did it during our vent days. I wouldn't be surprised if there was some granulation tissue growing there.

If he keeps HP for another day or two I'd look into having an x-ray done. The area could also be swollen from trauma. Keep a close eye on his sats.

babysupermansmommy · #4 10-07-2008, 04:35 PM

i try to only deep suction when he is really gunky.
Anthony has recently been taken off chromolyn sodium and has had a little cough, i wonder if it is swollen from that. I am asking his RT to come out and look at everything as well. We have never had a problem with granulation. how do they remove it when it is that far down?

just a little worried im due soon and i dont want anthony to end up in the hospital and me not be able to be there! i would feel awful. is it an outpatient thing? or overnight?

Ainsley's Mom · #5 10-08-2008, 02:35 AM

??? Okay. I just want to understand this. We try not to go down past the trach and stop at 6 cm on a Ped length trach. I had NO idea you could go down as far as you are. There have been a few times we thought we poked her by going down to like 7-8 when we were distracted. (Got pink secretions afterward.) Ainsley is TALL, like 34+ inches and she turns 2 next week. I don't mean to hijak your post, but is it possible we need to suction a little deeper just to get this junk in her lungs? She requires SO much suctioning! Maybe if we went down a little further it would actually get it up?

Anyway is Anthony's trach REALLY 12cm long? Ours isn't close to that. I can't think why it would have changed recently and I can understand why that concerns you. But if he's acting the same, no changes otherwise and satting at 100% that seems good. If he starts having other changes I would consult the drs.

saywhatyouwill · #6 10-08-2008, 08:18 AM

Quote:

Originally Posted by Ainsley's Mom

Ainsley is TALL, like 34+ inches and she turns 2 next week. I don't mean to hijak your post, but is it possible we need to suction a little deeper just to get this junk in her lungs? She requires SO much suctioning! Maybe if we went down a little further it would actually get it up?

wow that is tall.
this is probably an obvious question but are the secretions humidity related?

kshell · #7 10-08-2008, 10:55 AM

I would say the deep suctioning could have caused granulation tissue. Our hospital and ENT advise to never deep suction.
Good luck,

Karen

Mom2TwinsPlus1 · #8 10-08-2008, 11:34 AM

We suction to a 9, that puts us out of the trach about 3cm but doesn't get us the bottom, bottom for Emma is 12 cm. If we just go the length of the trach it doesn't get those lung buggers that hang just on the very end of the trach.

Wow 16-17 seems really deep to me. We deep suctio to our 12 or just above 12 when she is really really gunky with a plug or something, which is maybe 1 or 2 times a year. We were told that deep suctioning on some kids is a must, all the time even, but that the more you do the more likely chance of getting gran tissue is

T-bone · #9 10-08-2008, 11:53 AM

That seems deep to me. Abby is almost 8 and we go to a number 7 on the cath.

When we put in a new trach we put a cath in and where the end of the cath goes on the cannula, that is how we tell how far we go. We don't go past the cannula at all.

If you are going past that usually then it is quite possibly some ganuloma.

Perhaps you are using a different cath then some of us, with different numbers, but that does seem rather deep.

Susan, I wouldn't go any deeper then the end of the trach. Even if she has loads of secretions. Deep sx'ing should only be done if the person is in distress.

T

babysupermansmommy · #10 10-08-2008, 07:10 PM

ive always thought we go down deeper than normal ...12 is deep to me, i think his trach is 11cm long...which is very long, i have not been deep suctioning recently just only as needs, which is sometimes every day, anthony coughs up a lot of junk sometimes it just sits to low! i am going to messure a trach tube tonight just in case!

i know on some kids deep suctioning is a no no, and then on others its okay, i think it depends on the child and what the problem is. i figured with anthony having a smaller chest we would suction more shallow BUT if you think about it his lungs are more pushed to his tummy. so that kind of makes since!