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Quick Tip for Families in Intensive Care: My 83 Year Old Dad Has a Tracheostomy For 1 Month + 1 Liter of Oxygen. Can He Have The Tracheostomy Removed?

My dad had a tracheostomy for 1 month after he recovered from pneumonia. He still needs 1 liter of oxygen to support his breathing. Sometimes his oxygen levels steep down after physiotherapy. How can he be weaned off the tracheostomy?  What are the best nutritional supplements we can give him as he lost weight drastically in the last two months? My dad is 83 years of age.

This is a question from one of our readers who was asking that question. I will answer it today.

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

This is a question from Anne Marie. Thank you for sharing, Anne-Marie. It’s a big step that your dad is recovering from pneumonia and is using minimal oxygen support. Given his age and recent health challenges, careful planning is essential for weaning him off the tracheostomy and rebuilding his strength. Let’s look at weaning off the tracheostomy.

Here are some general steps typically followed under medical and nursing supervision.

Assessment by critical care nurses, pulmonologist or in the US, respiratory therapist, for evaluation of his airway patency, cough strength, ability to manage secretions and his ability to swallow. Oxygen needs and tolerance during rest and activity also need to be monitored.

Capping trials. The speaking valve or cap is placed on the tracheostomy tube for increasing durations  forcing air through the upper airway. And that also means for the capping trials, the tracheostomy cuff needs to be deflated so that air can flow freely. If he tolerates this without breathing distress or oxygen desaturation, then decannulation or tube removal is within the realm of possibility.

Also, reducing oxygen dependency. Monitor and gradually reduce supplemental oxygen as tolerated. Observe how he handles physiotherapy or exercise and exertion.

Next, pulmonary rehabilitation.  Controlled breathing exercises, chest physiotherapy, mild aerobic activity, even bed or chair-based help increase lung strength, coughing exercises as well.

What’s the decannulation criteria?

Stable vital signs, adequate oxygenation on room air, or minimal support, effective cough and secretion clearance and management, and tolerance of capped tracheostomy for several hours.

You could also try a non-cough tracheostomy. Like I said, the cuff needs to be down. Or you can try an uncuff tracheostomy. Obviously, the multidisciplinary team needs to be in alignment and needs to agree that it’s safe for the tracheostomy to be removed.

Now, let’s look at nutritional support for weight gain and recovery.

Since he’s experienced significant weight loss, focused on high calorie, high protein, nutrient-dense nutrition. Oral supplements is safe to swallow. Entero Plus boost high protein, calorie dense and easy to digest. Protinex, Beneprotein powder, add to meals or shakes. Glucerna, if diabetic, manages blood sugar while providing nutrients. Homemade high calorie options, smoothies, Greek yogurt, nut butter, banana, oats, protein powder. Soups, add cream, eggs or powdered milk for calorie boosts, soft snacks, avocados, boiled eggs, cheese, mashed potatoes with butter.

Tube feeding, if PEG (Percutaneous Endoscopic Gastrostomy) or nasogastric tube is still in place and required, consider formulas like Jevity, Nutren, or Isosource which offer balanced nutrition. Add modular supplements, protein, fiber, or calorie boosters under dietician supervision, and of course, check vitamin D, B12, and zinc levels as deficiencies can affect strength and healing.

I hope that helps you answer your question. And I know, some of our viewers here, they might have a family member in a very similar situation. Hopefully, we were able, or I was able to help you as well with this video.

Now, I have worked in critical care nursing for 25 years in 3 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 that we have saved many lives with our consulting and advocacy, and you could verify that on our intensivecarehotline.com testimonial or you can verify it on our intensivecarehotline.com com podcast section at intensivecarehotline.com, where we have done client interviews. You can listen to those interviews and you can hear their stories how we help them to save their loved one’s lives.

Because our advice is absolutely life changing. And we have helped hundreds and hundreds of members and clients over the years, and you can join a growing number of members and clients that we have helped over many years.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. And I talk to you and your families directly. I hand hold you through this once in a lifetime situation that you simply cannot afford to get wrong. I also talk to doctors and nurses directly with you on your behalf. And when I talk to doctors and nurses directly, 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. When I talk to doctors and nurses directly, I also represent you in family meetings with intensive care teams so that you have clinical advocacy representation in those meetings, which is critically important for the success of your loved one’s care.

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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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