• Carina Escudero, Fernanda Chiarion Sassi, Gisele Chagas de Medeiros, de LimaMaíra SantilliMSDivisão de Fonoaudiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil., CardosoPaulo Francisco GuerreiroPFGDepartamento Cardiopneumologia, Disciplina de Cirurgia Torácica da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil., and de AndradeClaudia Regina FurquimCRFDivisão de Fonoaudiologia do Instituto Central do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: clauan@usp.br..
• Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
• Clinics (Sao Paulo). 2022 Jan 1; 77: 100071.

ObjectiveTo investigate the clinical and swallowing indicators related to a successful decannulation process during the hospital stay.MethodsA retrospective cohort clinical study. The study sample comprised a heterogeneous patient population who had submitted to a tracheostomy procedure in a tertiary hospital. Patients were divided into two groups (decannulated vs. non-decannulated) and compared not only in terms of demographic and clinical data but also the results of a swallowing assessment and intervention outcome.ResultsSixty-four patients were included in the present study: 25 (39%) who had been successfully decannulated, and 39 (61%) who could not be decannulated. Between-group comparisons indicated that both groups presented similar clinical and demographic characteristics. The groups also presented similar swallowing assessment results prior to intervention. However, significant differences were observed regarding the time to begin swallowing rehabilitation. The decannulated group was assessed nine days earlier than the non-decannulated group. Other significant differences included the removal of the alternate feeding method (72.0% of decannulated patients vs. 5.1% of non-decannulated patients) and the reintroduction of oral feeding (96.0% of decannulated patients vs. 41.0% of non-decannulated patients) and functional swallowing level at patient disclosure. The non-decannulated patient group presented higher death rates at disclosure.ConclusionThe results of the present study indicated that the following parameters were associated with a successful decannulation process: early swallowing assessment, swallowing rehabilitation, and improvement in the swallowing functional level during the hospital stay. The maintenance of low swallowing functional levels was found to be negatively associated with successful decannulation.Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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