Posted by Brian on January 02, 1998 at 20:11:38:

In Reply to: Re: Postoperative Complications with Tracheostomy posted by Cobi on January 02, 1998 at 17:15:04:

Mike,
A trach is effective, albeit extreme, treatment for obstructive sleep apnea, as it completely bypasses the upper airways, which are the anatomical site of obstruction. However, it will not affect the neurological impulse to breathe which originates in the brain, therefore the affect on central apnea will be nil. If the problem is one of chronic central apnea with O2 desaturation such as may constitute respiratory failure, mechanical ventilation may be indicated. If so, a trach represents the customary point of connection to the ventilator. (In case you aren't familiar with ventilators, they are "breathing machines" which deliver breaths to patients who cannot adequately breathe on their own.) As it bypasses the body's natural air filtration, warming, and humidification systems, a tracheostomy can be a point of invasion of pathogens and particulates, and the effects of dehydration. It also complicates talking and swallowing. A decision to opt for a trach should be made only after very careful consideration and consultation. A tracheostomy is not, on the other hand, a permanent step, and in most cases will heal over relatively quickly once the hardware is removed. Still, a tracheostomy represents a "last ditch" kind of effort.
Thanks for the opportunity to respond.
Hope this helps.
Brian

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