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Tracheostomy Decannulation - Respiratory Care

Tracheostomy DecannulationHeidi H O Connor MD and Alexander C White MDIntroductionProcess of Weaning and Routine DecannulationManaging Accidental DecannulationPost- Decannulation MonitoringDecannulation Failure and Alternatives to DecannulationSummaryTracheostomy tubes are placed for a variety of reasons, including failure to wean from mechanicalventilation, inability to protect the airway due to impaired mental status, inability to manageexcessive secretions, and upper-airway obstruction. A Tracheostomy tube is required in approxi-mately 10% of patients receiving mechanical ventilation and allows the patient to move to astep-down unit or long-term care hospital. The presence of a Tracheostomy tube in the trachea cancause complications, including tracheal stenosis, bleeding, infection, aspiration pneumonia, andfistula formation from the trachea to either the esophagus or the innominate artery.

decannulation guidelines make it difficult to predict wean-ing outcomes of individual patients.5-7 Clinically stable patients undergoing prolonged mechanical ventilation usu-

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  Mechanical, Ventilation, Ventilation mechanical, Tracheostomy decannulation, Tracheostomy, Decannulation

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