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Quick Tip for Families in Intensive Care: My 58 Yr Old Dad’s in ICU with Pulmonary Fibrosis Ventilated, is a Tracheostomy the Best Next Step?

If you want to know if a tracheostomy is the right next step for your family member in intensive care with pulmonary fibrosis and pneumonia, stay tuned! I’ve got news for you.

My name is Patrik Hutzel from intensivecarehotline.com, and I have another quick tip for families in intensive care.

So, Rebecca writes in, she says,

“Hi Patrik,

My dad is 58 years of age and he’s currently in ICU. He had pulmonary fibrosis, and he has been infected with pneumonia. He’s in an induced coma, and the doctors are trying to find an antibiotic that would work. The doctor mentioned a tracheostomy today as the next step.

Do you think this could possibly be a good decision in his condition? What are your thoughts? Would this even be effective with his condition and would this cause even more pain and suffering for him? I would really appreciate your insights.

From, Rebecca.”         

So, hi Rebecca, I’m really sorry for it, that you are going through this with your dad. Pulmonary fibrosis and pneumonia are both serious conditions, and I can only imagine how difficult this is for you and your family.  Tracheostomy is often considered in situations where a patient requires long-term ventilation support, especially if they have been intubated for an extended period of time, or usually 10 to 14 days with the inability of weaning off the ventilator and the breathing tube. It can certainly help to reduce damage to the vocal cords and make breathing support more manageable, especially in patients with pulmonary fibrosis. However, the effectiveness depends on how much lung function remains.

Since pulmonary fibrosis leads to scarring and stiffness in the lungs, the tracheostomy won’t reverse or improve lung function, but it could make prolonged ventilation more comfortable. Benefits are easier ventilation, tracheostomy is much more comfortable than a breathing tube through the mouth or the nose, reducing the risk of ventilator-associated pneumonia. Even though he already has pneumonia, it is less relevant, but there’s still a reduced risk of ventilator-associated pneumonia, also known as VAP, and better long-term breathing support if his lungs can still function to some degree. Also then, the ability to go home with, for example, a service like Intensive Care at Home, and you can find more information at intensivecareathome.com.

Concerns. Tracheostomy doesn’t really treat pulmonary fibrosis if his lungs are already too damaged. A tracheostomy won’t improve their ability to oxygenate his blood, but it might help to buy him time and prolong his life.

Risks of complications are infections, bleeding, difficulty weaning off the ventilator, might be concerned, and also a tracheostomy is obviously a surgical procedure.

Quality of life considerations. If he doesn’t recover enough lung function, he may remain dependent on ventilation, which could lead to difficult decisions about long-term care and quality of life. But once again, with solutions like Intensive Care at Home, you might want to consider that for your dad and go home with Intensive Care at Home and provide more quality of life at home instead of intensive care because basically, a ventilator and a tracheostomy long-term will confine patients, or will basically increase the need for intensive care nurses, 24 hours a day, unfortunately.

Since currently he’s in an induced coma, he wouldn’t feel pain from the procedure itself. However, if he was to wake up and remain on the ventilator long-term, his comfort with the tracheostomy, even though much better than a breathing tube, and ability to communicate, all would need to be considered.

The biggest question is really if his lungs will be able to sustain with a tracheostomy. If his fibrosis has progressed significantly, the tracheostomy might only prolong suffering without improving his prognosis. I don’t think that it’s not so much about suffering, it’s more about improving quality of life and what can be done at home. His overall lung function needs to be assessed and discussed, whether the intervention of a tracheostomy aligns with his overall chances of recovery and his wishes.

The other component here is, can he be put on a lung transplant, especially since he’s 50 years of age and very young. Can he be put on a lung transplant? Is a lung transplant an option? This is a question that you should ask. Also, is ECMO (Extracorporeal Membrane Oxygenation) an option? ECMO can buy time by putting the lungs on bypass. What that means is, the ECMO machine will take over the function of the heart and the lung for a period of time. Then, hopefully, a lung transplant can be made available. Those are questions that you need to ask.

Like I say over and over again, the biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care. That is exactly the question here.

The other question you need to ask the doctors is, if they know about Intensive Care at Home because Intensive Care at Home is the long-term viable option if your dad can’t come off the ventilator  and needs a tracheostomy where quality of life can be improved at home. But also, what are your dad’s wishes? That’s also a very important consideration.

With all of that said, I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say we have saved so many lives for our clients in intensive care, and we could do the same for you.

That is all documented and verified on our testimonial section at intensivecarehotline.com and also on our intensivecarehotline.com podcast section, where we have done client interviews.

You can hear what our clients say that we have helped them to save their loved ones’ lives just with our intensive care insights that we have. Our advice is absolutely life changing. You can see that on our case studies, you can see it on our podcast section, you can see it on our website that our advice is life changing and has saved lives. You can join a growing number of clients and members that we have helped over the years in intensive care.

That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to doctors and nurses directly, which I also do, I ask all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

All of that you get at intensivecarehotline.com where we also have a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email. We answer all questions intensive care related. You also have exclusive access to 21 eBooks and 21 exclusive videos that I’ve personally written and recorded, so that you make informed decisions, have peace of mind, control, power, and influence so that your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Like, comment, subscribe, and share the video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on a show. You will get notifications for the YouTube live if you are a subscriber to my YouTube channel or if you subscribe to my intensivecarehotline.com email newsletter at intensivecarehotline.com.

Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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