Ann Rehabil Med.  2015 Dec;39(6):964-970. 10.5535/arm.2015.39.6.964.

Care Status of the ALS Patients With Long-Term Use of Tracheostomy Tube

• Park YJ
• Lee J
• Kim SH
• Ko SH
• Shin MJ
• Chang JH
• Shin YB

• KMID: 2165623
• DOI: http://doi.org/10.5535/arm.2015.39.6.964

Abstract

OBJECTIVE
To evaluate the care status of the amyotrophic lateral sclerosis (ALS) patients with long-term use of tracheostomy tube by caregivers of ALS patients.
METHODS
A survey was conducted in the form of questionnaires to ALS patients and their caregivers. All measurements were performed by two visiting nurses. For statistical analysis, SPSS ver. 22.0 and Mann-Whitney U test on non-normal distribution were used.
RESULTS
In total, 19 patients (15 males and 4 females) and their caregivers participated in the survey. In the case of patients, the average duration of care was 5.9+/-3.7 years, and the mean periods of illness and tracheostomy were 5.3+/-3.2 years and 3.0+/-2.6 years, respectively. Replacement intervals were 14 days in 11 patients, 7 days in 4 patients, 28 days in 2 patients, and 21 days in 1 patient. One patient was unable to provide an accurate replacement interval. Eighteen (99%) caregivers had experience of adding volume to a cuff without pressure measure in the following instances: due to patients' needs in 7 cases, air leakage in 7 cases, and no reason in 4 cases. Mean pressure of tracheostomy cuff was 40+/-9.4 cmH2O, and air volume of tracheostomy cuff was 6.7+/-3.2 mL, but real mean volume was 7.0+/-2.9 mL. The number of suctioning for airway clearance was a mean 27.5+/-18.2 times a day.
CONCLUSION
According to this survey, we notice that almost all the patients and caregivers had an erroneous idea about cuff volume and pressure. Moreover, education and long-term professional care of tracheostomy cannot be overemphasized in this manner.

Keyword

Amyotrophic lateral sclerosis; Tracheostomy; Long-term care; Caregiver

MeSH Terms

Amyotrophic Lateral Sclerosis
Caregivers
Education
Humans
Long-Term Care
Male
Nurses, Community Health
Suction
Tracheostomy*

Figure

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  Fig. 1 (A) Tracheostomy tube without smart cuff manager. (B) Tracheostomy tube with smart cuff manager which controls the cuff pressure continuously.

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  Fig. 2 Most of caregivers experienced over-inflation on tracheostomy tube. The figure showed 78.9% of the patients have an abnormal high cuff pressure (normal range of cuff pressure, 25-35 cmH2O).

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  Fig. 3 Comparison of cuff inflation volume and pressure 4 patients, before and after imparting education.

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