Physiological effects of decannulation in tracheostomized patients

Abstract

Decannulation resulted in a dead space increase with no other detectable additional loading. It increased work of breathing by more than 30%. Decannulation deserves special attention in patients with restrictive respiratory disease.

Ventilatory assistance in patients with Duchenne muscular dystrophy

“…However, tracheostomy may also have a number of advantages: ventilation is more secure and effective, and direct airway suctioning can be performed during periods of airway hypersecretion. By reducing the work of breathing [10], tracheostomy may also reduce the number of hours of ventilatory support needed per day. In addition, swallowing can be preserved, and speech can be obtained during both inspiration and expiration in invasively ventilated patients [11].…”

A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

“…Therefore, UB bypasses the dead space above the larynx and functions similar to a tracheostomy. [16][17][18] Indeed, the reduction of dead space obtained with UB is close to that of breathing via a tracheostomy. 8 Finally, the limitations of our study may be listed as (1) only stable and well-compensated COPD patients were enrolled.…”

Characteristics of tracheostomy phonation valves

“…Except for valve 1, all of the studied valves presented resistances that were comparable or below this estimation of upper airway resistance. Considering that a tracheostomy tube placed in the trachea also generates resistances [6,7,23,24], this suggests that the use of a speaking valve, depending on the choice of the phonation valve, could place the subject in a situation where resistances are equal or even superior to natural total lung airway resistances.…”

“…Tracheostomy can reduce work of breathing (WOB) by .30% [6,7]. However, loss of verbal communication is one of the main disadvantages of this technique [8,9].…”