Tracheostomy is a common procedure in long-term ventilated patients and frequent in those with severe stroke. Decannulation not only involves removal of the tracheostomy cannula, but also evaluation of upper airway protection. The predictors of success provide an objective guide to minimize the time of permanence of the same. Currently there are no studies on predictors of decannulation success in neurocritical patients.
To analyze clinical and demographic data in a cohort of tracheostomized neurocritical adults in the Intensive Care Unit over a period of 9 months. Secondarily, to compare decannulated and non-decannulated patients to identify variables associated with decannulation success.
We have analyzed the data of adult neurocritical tracheostomized patients during a stay in the Intensive Care Unit.
≥ 18 years, neurocritical tracheostomized patients.
Epidemiological data and personal antecedents, clinical follow-up variables: tracheostomy indication, tracheostomy timing, success of weaning, days of mechanical ventilation, success of decannulation, stay in Intensive Care Unit and ward, condition to discharge.
Prospective cohort study. Many of 32 patients were analyzed. Most frequent reason for admission was subarachnoid hemorrhage. The suspicion of prolonged weaning was the main criteria to perform a tracheostomy. Decannulation rate was 25%.
When comparing decannulated/non-decannulated patients, statistically significant differences were found in age (p = 0.037), tracheostomy timing (p = 0.001), tracheostomy motive: suspicion of prolonged weaning (p = 0.004) and prolonged mechanical ventilation (p = 0.009); Successful weaning (100% vs. 54% respectively p = 0.029) and discharge condition.
When analyzing clinical and demographic data, a greater percentage of females and subarachnoid hemorrhage was observed as a reason for more frequent admission. Both the suspicion of prolonged weaning and the prolonged mechanical ventilation were predominant causes of tracheostomy. The 66% of the tracheostomies were successfully removed; Decannulation rate was of 25%. When comparing decannulated and non-decannulated patients, significant differences were found in age, timing and reasons for tracheostomy, success in weaning, and condition at discharge. In those patients with successful decannulation, younger age, greater timing of tracheostomy and prolonged mechanical ventilation were observed as a reason for predominant tracheostomy.