Sarah gets more help breathing after transplants

A breathing tube was surgically placed in Sarah Murnaghan's throat Friday, her mother reported in a Facebook post.

The 10-year-old Newtown Square girl, who received a double-lung transplant at Children's Hospital of Philadelphia on June 12 and another transplant June 15 after the first one failed, has needed a breathing machine since the operations.

Janet Murnaghan said the new procedure, known as a tracheotomy, was needed because Sarah has been on long-term ventilator support and the weaning has been slow. Sarah is now being treated with antibiotics for pneumonia.

During a tracheotomy, doctors create an opening in the neck to place a tube from the ventilator into the trachea or windpipe.

On Friday morning, Janet Murnaghan posted that her daughter was "out of surgery and resting comfortably." She added: "I am relieved that it is over, and it is a joy to see my babies face again without tape and tubes!"

Gerard Criner, a pulmonologist who directs the Temple Lung Center but was not involved with Sarah's case, said the shorter, wider tube placed during a tracheotomy has several advantages. It allows patients to breathe and move around more easily. It is less likely to damage vocal cords and is easier for hospital staff to clean. Some patients are able to talk and eat after a tracheotomy.

Criner said some studies have shown that tracheotomies make it easier to wean a patient off the breathing machine.

Stuart Sweet, director of the lung-transplant program at St. Louis Children's Hospital, said: "What it tells me is that the transplant team is acknowledging that it's going to be a long recovery."

The tracheotomy will allow Sarah to be more comfortable and to participate more fully in rehabilitation, Sweet said. Without a tracheotomy, patients on ventilators often require sedation.

Janet Murnaghan said on Facebook that the procedure was meant to be temporary.

Sarah has cystic fibrosis. Her family won a public fight to change transplant rules so that she could have access to the adult donor lungs that were used for both transplants.