PDF(Pubmed)
Abstract：
BACKGROUND: Adequate cough or exsufflation flow can indicate an option for safe tracheostomy decannulation to noninvasive management. Cough peak flow via the upper airways with the tube capped is an outcome predictor for decannulation readiness in patients with neuromuscular impairment. However, this threshold value is typically measured with tracheotomy tube removed, which is not acceptable culturally in China. The aim of this study was to assess the feasibility and safety of using cough flow measured with tracheostomy tube and speaking valve (CFSV) > 100 L/min as a cutoff value for decannulation.
METHODS: Prospective observational study conducted between January 2019 and September 2022 in a tertiary rehabilitation hospital.
METHODS: Patients with prolonged tracheostomy tube placement were referred for screening. Each patient was assessed using a standardized tracheostomy decannulation protocol, in which CFSV greater than 100 L/min indicated that the patients\' cough ability was sufficient for decannulation. Patients whose CFSV matched the threshold value and other protocol criteria were decannulated, and the reintubation and mortality rates were followed-up for 6 months.
RESULTS: A total of 218 patients were screened and 193 patients were included. A total of 105 patients underwent decannulation, 103 patients were decannulated successfully, and 2 patients decannulated failure, required reinsertion of the tracheostomy tube within 48 h (failure rate 1.9%). Three patients required reinsertion or translaryngeal intubation within 6 months.
CONCLUSIONS: CFSV greater than 100 L/min could be a reliable threshold value for successful decannulation in patients with various primary diseases with a tracheostomy tube.
BACKGROUND: This observational study was not registered online.
METHODS: Prospective observational study conducted between January 2019 and September 2022 in a tertiary rehabilitation hospital.
METHODS: Patients with prolonged tracheostomy tube placement were referred for screening. Each patient was assessed using a standardized tracheostomy decannulation protocol, in which CFSV greater than 100 L/min indicated that the patients\' cough ability was sufficient for decannulation. Patients whose CFSV matched the threshold value and other protocol criteria were decannulated, and the reintubation and mortality rates were followed-up for 6 months.
RESULTS: A total of 218 patients were screened and 193 patients were included. A total of 105 patients underwent decannulation, 103 patients were decannulated successfully, and 2 patients decannulated failure, required reinsertion of the tracheostomy tube within 48 h (failure rate 1.9%). Three patients required reinsertion or translaryngeal intubation within 6 months.
CONCLUSIONS: CFSV greater than 100 L/min could be a reliable threshold value for successful decannulation in patients with various primary diseases with a tracheostomy tube.
BACKGROUND: This observational study was not registered online.
摘要：
背景：充分的咳嗽或排气流量可以指示安全的气管造口术拔管与非侵入性管理的选择。经导管加帽的上气道的咳嗽峰值流量是神经肌肉障碍患者拔管准备的结果预测指标。然而,此阈值通常是在移除气管切开术管时测量的，这在中国文化上是不可接受的。这项研究的目的是评估使用气管造口管和说话瓣膜（CFSV）>100L/min测量的咳嗽流量作为拔管的临界值的可行性和安全性。
方法：2019年1月至2022年9月在三级康复医院进行的前瞻性观察性研究。
方法：气管切开置管时间延长的患者进行筛查。使用标准化的气管造口术拔管方案评估每位患者，其中CFSV大于100L/min表明患者的咳嗽能力足以进行拔管。CFSV与阈值和其他方案标准匹配的患者被拔管，随访6个月的再插管率和死亡率。
结果：共筛查了218例患者，纳入了193例患者。共有105名患者接受了拔管,103例患者成功拔管,2名患者拔管失败，需要在48小时内重新插入气管造口管（失败率1.9％）。3例患者需要在6个月内重新插入或经喉插管。
结论：CFSV大于100L/min可能是具有各种原发性疾病的患者使用气管造口管成功拔管的可靠阈值。
背景：这项观察性研究未在网上注册。
方法：2019年1月至2022年9月在三级康复医院进行的前瞻性观察性研究。
方法：气管切开置管时间延长的患者进行筛查。使用标准化的气管造口术拔管方案评估每位患者，其中CFSV大于100L/min表明患者的咳嗽能力足以进行拔管。CFSV与阈值和其他方案标准匹配的患者被拔管，随访6个月的再插管率和死亡率。
结果：共筛查了218例患者，纳入了193例患者。共有105名患者接受了拔管,103例患者成功拔管,2名患者拔管失败，需要在48小时内重新插入气管造口管（失败率1.9％）。3例患者需要在6个月内重新插入或经喉插管。
结论：CFSV大于100L/min可能是具有各种原发性疾病的患者使用气管造口管成功拔管的可靠阈值。
背景：这项观察性研究未在网上注册。
