Abstract
The assessment of when and under what conditions decannulation should take place is the responsibility of the medical disciplines in close cooperation with therapists and nurses. This chapter, which is important for decannulation, contains the answers to the questions under which conditions, when, where and how decannulation is to be performed and which diagnostic steps are associated with it. The identification of impaired functionality and its therapeutic measures as well as the stage program for weaning are dealt with in detail. The chapter gives detailed consideration to possible pathological changes in the respiratory tract, secretion management, assessment of the swallowing function and diagnostic and therapeutic options for dysphagia of various causes. Clear decision criteria for planning the decannulation are taught. Decannulation is described in a practice-oriented way with all follow-up measures and made understandable by means of clear representations and illustrations. Tracheostomy tube-related risks, questions of quality of life and the care of tracheotomized patients are dealt with in detail.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alvo A, OlavarrÃa C. Decannulation and assessment of deglutition in the tracheostomized patient in non-neurocritical intensive care. Acta Otorinolaringol Esp. 2014;65(2):114–9.
Garuti G, et al. Swallowing disorders in tracheostomized patients: a multidisciplinary/multiprofessional approach in decannulation protocols. Multidiscip Respir Med. 2014;9(1):36.
Schneider-Stickler B. Die Dekanülierung. In: Schneider-Stickler B, Kress P, editors. Tracheotomie und Tracheostomaversorgung. Austria: Springer; 2018. p. 347–53.
Rosseau S, et al. Tracheostomy home care of patients after long term ventilation on the ICU – a position paper. Pneumologie. 2017;71:204–6.
Tolotti A, et al. The communication experience of tracheostomy patients with nurses in the intensive care unit: a phenomenological study. Intensive Crit Care Nurs. 2018;46:24–31.
Schneider-Stickler B, et al. Indikationen zur Tracheotomie. In: Schneider-Stickler B, Kress P, editors. Tracheotomie und Tracheostomaversorgung. Austria: Springer; 2018. p. 103–47.
Richter T, Sutarski S. Tracheostoma. Handling and complications. Anaesthesist. 2009;58(12):1261–74. German.
Stelfox HT, et al. Research. Determinants of tracheostomy decannulation: an international survey. Crit Care. 2008;12:R26.
Heffner JE. Commentary. Tracheostomy decannulation: marathons and finish lines. Crit Care. 2008;12:128. https://doi.org/10.1186/cc6833.
Hosokawa K, et al. Timing of tracheotomy in ICU patients: a systematic review of randomized controlled trials. Crit Care. 2015;19:424. https://doi.org/10.1186/s13054-015-1138-8.
Schröter-Morasch H. Klinische Untersuchung des Oropharynx und videoendoskpische Untersuchung der Schluckfunktion. In: Bartolome G, Schröter-Morasch H, editors. Schluckstörungen – Diagnostik und Rehabilitation. München: Urban & Fischer; 2014a. p. 167–204.
Byrd JK, et al. Predictors of clinical outcome after tracheotomy in critically Ill obese patients. Laryngoscope. 2014;124(5):1118–22.
Diaz-Abad M, et al. Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation. Respir Care. 2012;57(2):229–37.
Budweiser S, et al. Predictors of successful decannulation using a tracheostomy retainer in patients with prolonged weaning and persisting respiratory failure. Respiration. 2012;84(6):469–76.
Bach JR, Takyi SL. Physical Medicine Interventions to Avoid Acute Respiratory Failure and Invasive Airway Tubes. PM R. 2015;7(8):871–7.
Seidl RO, Nusser-Müller-Busch R. Die Trachealkanüle: Segen und Fluch. In: Nusser-Müller-Busch R, editor. Die Therapie des Facio-Oralen Trakts. Berlin: Springer; 2004. p. 148–61.
Arens C, Herrmann IF, Rohrbach S, Schwemmle C, Nawka T. Position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology- current state of clinical and endoscopic diagnostics, evaluation, and therapy of swallowing disorders in children and adults. Laryngorhinootologie. 2015;94:S306–54. German.
Schröter-Morasch H. Medizinische Basisversorgung von Patienten mit Schluckstörungen – Trachealkanülen – Sondenernährung. In: Bartolome G, Schröter-Morasch H, editors. Schluckstörungen – Diagnostik und Rehabilitation. München: Urban & Fischer; 2014b. p. 207–50.
Skoretz SA, Riopelle SJ, Wellman L, Dawson C. Investigating swallowing and tracheostomy following critical illness: a scoping review. Crit Care Med. 2019; https://doi.org/10.1097/CCM.0000000000004098.
Winck JC, et al. The value of cough peak flow measurements in the assessment of extubation or decannulation readiness. Port Pneumol. 2006;21(2):94–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sutarski, S. (2020). The Way to Decannulation. In: Klemm, E., Nowak, A. (eds) Tracheotomy and Airway. Springer, Cham. https://doi.org/10.1007/978-3-030-44314-6_17
Download citation
DOI: https://doi.org/10.1007/978-3-030-44314-6_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-44313-9
Online ISBN: 978-3-030-44314-6
eBook Packages: MedicineMedicine (R0)