Aspiration in tracheotomized patients

In the ICU, tracheal tubes are inflated to prevent air leakage during mechanical ventilation as well as to avoid aspiration from impaired swallowing. Aspiration of small amounts of 

In summary, whereas for obvious reasons the immediate focus in patients with ventilatory failure is the prompt initiation of effective mechanical ventilatory support, it is also necessary for the health care professional to be mindful of the management of other aspects of their care, such as bronchodilators, steroids, antibiotics, and oxygen as well as issues such as secretion clearance, positioning, mobilization, and the potential for aspiration, especially among those patients ventilated through a tracheostomy. Many of these points are amplified elsewhere in this text. 

Schucher B, Laier-Groeneveld G, Huettemann U, et al. Effects of intermittent self-ventilation on ventilatory drive and respiratory pump fimction. Med Klin (Munich) 1995 90(1 suppl 1) 13-16. 

Windisch W, Kostic S, Dreher M, et al. Outcome of patients with stable COPD receiving controlled noninvasive positive pressure ventilation aimed at a maximal reduction of Pa(C02). 

Rennard SI, Calverly PM A. Bronchodilaters in chronic obstructive pulmonary disease. In Sifiakas NM, ed. Management of chronic obstructive pulmonary disease. Eur Respir Mon 2006  

---