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Monaldi Arch Chest Dis · May 1995
Indications for tracheostomy and decannulation of tracheostomized ventilator users.
- J R Bach.
- Dept of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
- Monaldi Arch Chest Dis. 1995 May 1; 50 (3): 223-7.
AbstractVentilator users whose airway secretions can be effectively cleared do not require intubation or tracheostomy for ventilatory support, despite possibly having no measurable vital capacity and no significant ventilator-free breathing time (VFBT). Likewise, ventilator users receiving intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy can be safely decannulated and converted to the use of noninvasive ventilatory support methods provided that a minimum of 3 L.s-1 of peak cough expiratory flow (PCEF) can be achieved by unassisted coughing or by the use of manually- or mechanically-assisted coughing techniques. The use of up to 24 h.day-1 noninvasive ventilatory support is preferred by patients and caregivers over tracheostomy IPPV, and is less costly, and appears to be associated with fewer long-term complications.
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