Bronchial suction by minitracheotomy as an effective measure against sputum retention.

Bronchial suction by means of a minitracheostomy is a new method for treatment of sputum retention and related pulmonary diseases. Through a small coniotomy, a specially designed cannula is inserted into the trachea, allowing frequent bronchial suction. The effectiveness of this method was prospectively analyzed in 74 consecutive patients and the results were compared with those reported in the literature. The operative procedure for insertion of the Minitracheotomy cannula caused nonlethal bleeding in three patients who were receiving anticoagulant medications. Thirty-eight of 43 patients treated on the intensive care ward were detubated and dismissed at an earlier stage than usual because of a minitracheostomy. The method failed in two comatose patients and in one patient with a laryngeal tumor. The method was effective in 18 patients who had serious pulmonary disease postoperatively. Thirteen patients at high risk for pulmonary infections, in whom the cannula had been prophylactically applied after extensive operations, did not have postoperative pulmonary complications. Over-all, the median period for bronchial suction was 4.0 days; decannulation followed on average 4.7 days later. No complications were caused by the presence of the cannula and the device was well tolerated by the patients.