Preliminary study on a proposal of an interdisciplinary flowchart of tracheostomy decannulation

Abstract

Objective: To evaluate the weaning steps of decanulation in patientsadmitted at the Semi-intensive Care Unit of the Hospital IsraelitaAlbert Einstein, following a protocol proposed and developed byPhysical Therapy and Phonoaudiology specialists, with a focus oninterdisciplinary actions and also to analyze the values of ventilatory measurements, weaning complications and the relation between success and decanulation mean time. Methods: A weaningand decanulation flowchart was applied to a population of 21tracheostomized patients with several diagnoses. All patients metthe basic criteria for the weaning procedure. Maximum inspiratorypressure (MIP), maximum expiratory (MEP), vital capacity andpeak cough flow data were analyzed. Results: In the populationsubject of this study, patients presented an average peak coughflow value of 174.74 l/min in the beginning of the weaning, standarddeviation = 58.03, with a lower value of 80 and higher of 310 l/min.All patients who were decanulated presented MIP > -30cmH2O.In this preliminary study, the MEP and the MIP measure have notdemonstrated to be an effective measure for the sake of data analysisas success predictors. Conclusions: This study revealed that theweaning and decanulation of tracheomatized patients is moreefficient and safer when there is an interdisciplinary participationand that available data are still at a preliminary stage and they point out the need of further studies over a larger population.

Keywords

• Weaning
• Tracheostomy