Decannulation Timing

sofiasmom · #1 08-23-2010, 02:14 PM

Is it a general rule NOT to decannulate from late Sept through March? I'm worried that if we miss this window soon, we're stuck until the spring. All of Sofia's bronchs since her surgery have shown issues, usually to an undiagnosed illness causing inflammation. Today her nose started running so I called ENT and will see if we need to postpone (and again delay!).

bryantem · #2 08-23-2010, 02:18 PM

Our ENT and Pulm will decannulate any time of the year.

saywhatyouwill · #3 08-23-2010, 02:44 PM

Quote:

Originally Posted by bryantem

Our ENT and Pulm will decannulate any time of the year.

same here. emily was decannulated end september into october.

kadiera · #4 08-23-2010, 02:59 PM

Ours won't decan during the winter...

...but I bet it depends on the child, and their reason for having a trach.

I could see a kid with structural issues and no history of O2 being fine once they're resolved, no matter what the time of year.

I know our docs are super conservative with Alexander because his issues are all lung related, and every illness bigger than a cold has required a bump in O2 - this week he's back on 1L after being off completely for portions of the day 2 weeks ago, all due to some virus that's "going around"

rosi's mom · #5 08-23-2010, 03:24 PM

Ours won't go past October, sometimes earlier depending on whether RSV has come into the hospital yet or not. Then they'll try again in May. They try to not decannulate in the RSV season because there will be cases in the PICU and on the floor, plus other illnesses that would affect the lungs.

KJKK8437 · #6 08-23-2010, 06:24 PM

Our pulm said it was child specific. He had no hard and fast rule, although I know that lung health played a major role in his decision. PLUS, he would not put a child on a PICU for attempted decann if the PICU was loaded with RSV. The child's trachea immediately after decann is weaker than a child who never had a trach, and it needs some time to heal, and he won't take a child into a situation where there is an active and immediate risk of infection.

While I never specifically asked him, I also suspect he would not decannulate a school aged child, or a child who was similarly exposed, during winter if the annual respiratory virus and flu was hard hitting like it has been the last 3 years.

Our ENT will perform LTPs year-round. I have no idea what his policy was on non-surgical decanns.

faywrayy · #7 08-23-2010, 08:19 PM

I assumed this very thing. Kate was initially scheduled for a double stage Ltp 5/1/08. We hoped for decann by summer. She got sick and we had to postpone to 7/3/08, hoping for decann by early fall. We assumed if she missed this window, she'd stay trached until the following spring. I asked the ENT this, but he said he'd decann anytime of the year, as long as she was ready. This suprised me because I knew of another child treated by the same ENT whose mom told me he wouldn't decann during the winter. I can only assume this was because of different health issues the other child faced (lung issues I believe) whereas Kate's issues were purely airway.