Determinants of tracheostomy decannulation: an international survey

Abstract

Background Although tracheostomy is probably the most common surgical procedure performed on critically ill patients, it is unknown when a tracheostomy tube can be safely removed.

Impact of a specialized multidisciplinary tracheostomy team on tracheostomy care in critically ill patients

“…With a specialized service, decisionmaking is centralized to those with the required expertise, which leads to more consistent evidence-based management. However, even among those clinicians with experience in tracheostomy care, Stelfox and colleagues 6 reported that significant variability in opinions existed concerning the appropriate timing for decannulation. This is true in part because guidelines for tracheostomy management do not exist.…”

Peak Flow Rate During Induced Cough: A Predictor of Successful Decannulation of a Tracheotomy Tube in Neurosurgical Patients

“…This outcome is considered satisfactory, because only 2 patients required reintubation and those patients who were not recommended for decannulation were transferred to a convalescent hospital and were reevaluated at a later date. Predictors of successful decannulation include level of consciousness, secretions, oxygenation, 19 and the ability to produce a vigorous cough. 20 Irrespective of the method used to measure cough strength, a consistent association between cough and extubation/decannulation outcomes has been reported.…”

Proyecto de seguridad del paciente traqueotomizado procedente de una unidad de cuidados críticos.

“…Hay pocos estudios que expresen la circunstancia idónea para decanular y están basados fundamentalmente en la experiencia personal de sus autores [42]. En base a la literatura publicada [8,13,27,37,[43][44][45][46][47], aplicamos actualmente el protocolo de la Tabla 2, junto a la evaluación fibroendoscópica ya descrita [28]. Pero nuestra mejor referencia es la que obtenemos de la evaluación continuada, de las posibles emergencias y del permanente contacto con el paciente.…”