Management of an existing tracheostomy tube in a patient who will undergo anesthesia

This algorithm does not apply to the patient with a t-tube in place. The algorithm should be used in conjunction with UpToDate content on airway management for anesthesia for the adult with a tracheostomy.

* Tracheostomy tube exchange during the first week after tracheostomy is associated with increased risk of potentially severe complications (eg, creating a false passage, hemorrhage, pneumothorax, pneumomediastinum, infection).

¶ Use of inhaled anesthetics with an uncuffed tube pollutes the operating room with those gases.

Δ At the end of anesthesia the tracheal tube should be exchanged back to the patient's original tracheostomy tube.

◊ At the end of anesthesia the surgeon should exchange the tracheal tube for the patient's original tracheostomy tube.

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Management of an existing tracheostomy tube in a patient who will undergo anesthesia