Predictors of decannulation

Abstract

Tracheostomy (TQT) is common in intensive care patients with prolonged mechanical ventilation, performed in about 34% of these patients. Prioritizing successful decannulation is crucial as it can reduce mortality and hospital stay duration, thereby lowering the risk of infections. Studies indicate that failed decannulation increases mortality and public health costs. Several critical variables for successful decannulation were identified, such as age, sex, comorbidities, level of consciousness, structural airway alterations, swallowing disorders, duration of mechanical ventilation, and effectiveness of cough and muscle strength. Studies show that advanced age and male sex are significant risk factors, while tolerance to cannula occlusion for more than 24 hours and a peak cough flow greater than 160 L/min are crucial success indicators. Structural airway evaluation through endoscopy is also determinant. Correctly recognizing and evaluating these variables can facilitate the decision on the feasibility of decannulation and improve long-term patient outcomes