The Science Journal of the American Association for Respiratory Care
Background: When the upper airway is bypassed respiratory complications are common in patients who are managed with tracheotomy. Under these circumstances it is important to measure lung function in these patients in order to gain a more complete understanding regarding early detection of pulmonary disease, and the evaluation of the therapy and management, particularly in survivors of laryngeal cancer. The aim of this study was to objectively assess the changes in pulmonary function parameters after tracheotomy and understand possible clinical applications for pulmonary function tests (PFT) in these patients.
Methods: 15 adult heavy smokers diagnosed with laryngeal cancer and managed by tracheotomy after surgical tumor resection were included in this research group. Preoperative basic pulmonary function datas (FVC, FEV1, FEV1/FVC, FEF%25-75, Peak Flow) were compared with postoperative datas measured on the first, fifth, and tenth day after tracheotomy. We also compared pulmonary function results before and after chest physical therapy in this group of patients.
Results: A highly significant (p<0.001) change in reduction of pulmonary function test parameters was found in postoperative data when compared with the preoperative date. In comparison of PFT results before and after chest physical therapy there were significant increases (p<0.05) in forced vital capacity (FVC), forced mid-expiratory flow rate (FEF%25-75), and a significant decrease (p<0.05) in PaCO2 blood gas values, while the forced expiratory volume in one second (FEV1), percentage of the forced vital capacity (FEV1/FVC), peak flow, and PaO2 blood gas values demonstrated no significant differences (p>0.05).
Conclusions: Our study findings suggest that the resection of the larynx possibly has an influence on these PFT parameters by decreasing the deadspace. Also, the differences in PFT results before and after chest physical therapy shows us that this therapy results in better PFT test results with these patients. Due to technical and standardization difficulties, and a lack of existing predicted pulmonary function test values for tracheostomized patients it is important to develop a different approach in the management of these patients.