Failure to Improve Effective Ventilation on Shifting from Mouth to Tracheostomy Breathing in Clinically Stable Emphysema

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Abstract
THE use of tracheostomy in the therapy of patients with pulmonary emphysema has become a well established practice. The benefits are gained from the easy removal of secretions in the acutely ill patients and its short-term use has been recommended after chest trauma,1 in the operative management of patients with obstructive disease of the lungs2 and in the treatment of those with bronchial pneumonia as an exacerbation of their underlying emphysema.3 Recently, however, it has been advocated on a long-term basis in chronically ill patients who have secretions that are difficult to eliminate.4 There is another potential advantage to the . . .