Safety evaluation of a stepwise tracheostomy decannulation program in pediatric patients

Purpose In the event of failed tracheostomy decannulation, patients might have a tragic course of events. We retrospectively evaluated our stepwise tracheostomy decannulation program and examined its safety. Methods A 12-year retrospective study of pediatric patients was conducted. The decannulation program was performed on patients who had airway patency by laryngobronchoscopy and whose cannula could be capped during the day. A stepwise decannulation program was performed: continuous 48-h capping trial during hospitalization (Phase 1), removal of the tracheostomy tube for 48 h during hospitalization (Phase 2), and outpatient observation (Phase 3). If a persistent tracheocutaneous fistula existed, the fistula was closed by surgery (Phase 4). Results The 77 patients in the study underwent 86 trials. The age at the first time of the decannulation program was 6.5 ± 3.6 years. Sixteen trials failed (18.6%): 8 trials in Phase 1, 2 trials in Phase 2, 4 trials in Phase 3, and 2 trials in Phase 4. Most decannulation failures were due to desaturation in Phase 1/2 and dyspnea in Phase 3/4. The time to reintubation after decannulation was 15–383 days in Phase 3/4. Conclusions Patients could fail at every phase of the program, suggesting that a stepwise decannulation program contributes to safety..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:39

Enthalten in:

Pediatric surgery international - 39(2023), 1 vom: 02. Sept.

Sprache:

Englisch

Beteiligte Personen:

Obayashi, Juma [VerfasserIn]
Fukumoto, Koji [VerfasserIn]
Yamoto, Masaya [VerfasserIn]
Miyake, Hiromu [VerfasserIn]
Nomura, Akiyoshi [VerfasserIn]
Kanai, Risa [VerfasserIn]
Nemoto, Yuri [VerfasserIn]
Tsukui, Takafumi [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Airway management
Child
Decannulation
Tracheocutaneous fistula
Tracheostomy

RVK:

RVK Klassifikation

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s00383-023-05549-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC214537812X

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