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A prospective comparative study of the functional results associated with the use of Björk flap tracheostomy versus standard tracheostomy

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background

Placement of a tracheostomy for patients requiring prolonged mechanical ventilation (PMV) improves patients’ comfort, decreases dead space ventilation, allows superior airway hygiene, and reduces the incidence of ventilator-associated pneumonia. Controversy still exists regarding the role of standard tracheostomy (ST) as opposed to the less frequently done Björk flap tracheostomy (BFT). This study compares the functional outcomes of these two techniques.

Study design

Seventy-nine patients receiving tracheostomy in a 12-month period: 38 BFT vs. 41 ST. Data included demographics, indications for PMV, ventilator days before tracheostomy, time to and a number of patients who passed the fiberoptic endoscopic evaluation of swallowing (FEES), time to and a number of patients decannulated.

Results

Indications in both groups were PMV from trauma (18/38 vs 15/41), pneumonia (13/38 vs 13/41), and ARDS (7/38 vs 11/4), respectively (p > 0.05). Patients in both groups did not differ with regard to age, sex, GCS, duration of PMV before tracheostomy, the time to and a number of patients who passed the 1st FEES. However, the number of days and the number of FEES required before the next successful FEES in the 20 BFT and 21 ST patients who failed the 1st was 9 (4) vs. 16 (5), and 2 (1) vs. 4 (1), respectively (p < 0.05). Additionally, the number of intraoperative complications in aggregate were 0/38 in the BFT as opposed to 6/41 in the ST group (p < 0.05).

Conclusion

We conclude that BFT may be associated with an overall shorter time to restoration of normal swallowing when compared to ST.

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Data Availability

Not applicable.

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Authors and Affiliations

  1. Jacobi Medical Center, Bronx, NY, USA

    Corrado P. Marini, John McNelis & Erin Lewis

  2. Westchester Medical Center, Valhalla, NY, USA

    Erin McMurdo & Anthony Policastro

  3. Morristown Medical Center, Morristown, NJ, USA

    Gary Lombardo

  4. St. Barnabas Hospital, Bronx, NY, USA

    Dmitry Karev

  5. Department of Surgery, NYU Long Island School of Medicine, NYU Langone Hospital-Long Island, 222 Station Plaza N., Suite 300, Mineola, NY, 11501, USA

    Patrizio Petrone

Authors
  1. Corrado P. Marini
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  2. Erin McMurdo
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  3. John McNelis
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  4. Erin Lewis
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  5. Anthony Policastro
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  6. Gary Lombardo
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  7. Dmitry Karev
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  8. Patrizio Petrone
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Contributions

Design: CPM, EM, AP, GL, DK. Drafting of the manuscript: CPM, EL, PP. Critical revision: CPM, JM, PP.

Corresponding author

Correspondence to Patrizio Petrone.

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Conflict of interest

Corrado P. Marini, Erin McMurdo, John McNelis, Erin Lewis, Anthony Policastro, Gary Lombardo, Dmitry Karev, and Patrizio Petrone declare that they have not a conflict of interest.

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This study does not need for an informed consent.

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Marini, C.P., McMurdo, E., McNelis, J. et al. A prospective comparative study of the functional results associated with the use of Björk flap tracheostomy versus standard tracheostomy. Eur J Trauma Emerg Surg 49, 1329–1335 (2023). https://doi.org/10.1007/s00068-023-02223-x

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  • DOI: https://doi.org/10.1007/s00068-023-02223-x

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