Outcomes of critical patients with tracheostomy: proposal of a decannulation protocol
© Duro et al.; 2015
Published: 1 October 2015
Tracheostomy (TCT) places an high social and economical burden not only for patients and their families, but also for institutions and the management of their beds. Longitudinal studies are contradictory, due to different non-standard practices, different circuits of these patients in the hospitals and the differentiation of human resources. Therefore, the creation of decannulation protocols can be of major importance.
1) To describe patients who underwent TCT in the Intensive Care Unit (ICU) and analyse their outcomes at 28 days and 6 months;
2) To determine if there is a relationship between the location of decannulation and the outcomes;
3) To propose a decannulation protocol.
Retrospective analysis of data collected in ICU of Faro Hospital, during 1 year and 3 months. Patients who underwent upper thoracic surgery and/or neck surgery, previous TCT and had decision to do not resuscitate, were excluded (n = 33). The following clinical data were collected: type of TCT (percutaneous vs surgical); reason for TCT; reason for ICU admission; age; hospital and ICU length of stay ; duration of mechanical ventilation (MV); early vs late percutaneous TCT duration; place of discharged. Follow up at 28 days and 6 months; failed attempts to decannulation; place of decannulation, readmission; and severity of disease at ICU admission. Chi-square tests for categorical variables, non-parametric Kruskal-Wallis and independent samples Student t test for continuous variables, were performed.
Understanding outcomes and trajectories of care in patients submitted to TCT was fundamental for the proposal of a decannulation protocol. Further studies are needed to evaluate the quality of life in TCT patients and provide further insights on this protocol optimization.
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