Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals
Abstract Background In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods From 09/2014 to 03/2016, 83...
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BMC
2018-06-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-018-0527-3 |
| _version_ | 1818340214041477120 |
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| author | Maria-Dorothea Heidler Annett Salzwedel Michael Jöbges Olaf Lück Christian Dohle Michael Seifert Andrea von Helden Wibke Hollweg Heinz Völler |
| author_facet | Maria-Dorothea Heidler Annett Salzwedel Michael Jöbges Olaf Lück Christian Dohle Michael Seifert Andrea von Helden Wibke Hollweg Heinz Völler |
| author_sort | Maria-Dorothea Heidler |
| collection | DOAJ |
| description | Abstract Background In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 ± 12.9 years, 68% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results Four hundred seventy patients (57%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic. |
| first_indexed | 2024-12-13T15:39:20Z |
| format | Article |
| id | doaj.art-fc0d214ea6104988baf00a3fc7c79c66 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-13T15:39:20Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-fc0d214ea6104988baf00a3fc7c79c662022-12-21T23:39:53ZengBMCBMC Anesthesiology1471-22532018-06-011811710.1186/s12871-018-0527-3Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitalsMaria-Dorothea Heidler0Annett Salzwedel1Michael Jöbges2Olaf Lück3Christian Dohle4Michael Seifert5Andrea von Helden6Wibke Hollweg7Heinz Völler8University of Potsdam, Center of Rehabilitation ResearchUniversity of Potsdam, Center of Rehabilitation ResearchBrandenburg Klinik BernauKliniken BeelitzMEDIAN Klinik Berlin-KladowMEDIAN Klinik GrünheideVivantes Klinikum SpandauVivantes Klinikum SpandauUniversity of Potsdam, Center of Rehabilitation ResearchAbstract Background In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. Methods From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 ± 12.9 years, 68% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e.g. relevant neurological and internistic diseases, duration of mechanical ventilation, tracheotomy technique, and nutrition) as well as functional assessments (Coma Recovery Scale-Revised (CRS-R), Early Rehabilitation Barthel Index, Bogenhausener Dysphagia Score) were collected. Complications and the success of the decannulation procedure were documented at discharge. Results Four hundred seventy patients (57%) were decannulated. The probability of decannulation was significantly negatively associated with increasing age (OR 0.68 per SD = 12.9 years, p < 0.001), prolonged duration of mechanical ventilation (OR 0.57 per 33.2 days, p < 0.001) and complications. An oral diet (OR 3.80; p < 0.001) and a higher alertness at admission (OR 3.07 per 7.18 CRS-R points; p < 0.001) were positively associated. Conclusions This study identified practically measurable predictors of decannulation, which in the future can be used for a decannulation prognosis and supply optimization at admission in the neurological early rehabilitation clinic.http://link.springer.com/article/10.1186/s12871-018-0527-3Mechanical ventilationTracheostomyDecannulationPrognosis |
| spellingShingle | Maria-Dorothea Heidler Annett Salzwedel Michael Jöbges Olaf Lück Christian Dohle Michael Seifert Andrea von Helden Wibke Hollweg Heinz Völler Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals BMC Anesthesiology Mechanical ventilation Tracheostomy Decannulation Prognosis |
| title | Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals |
| title_full | Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals |
| title_fullStr | Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals |
| title_full_unstemmed | Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals |
| title_short | Decannulation of tracheotomized patients after long-term mechanical ventilation – results of a prospective multicentric study in German neurological early rehabilitation hospitals |
| title_sort | decannulation of tracheotomized patients after long term mechanical ventilation results of a prospective multicentric study in german neurological early rehabilitation hospitals |
| topic | Mechanical ventilation Tracheostomy Decannulation Prognosis |
| url | http://link.springer.com/article/10.1186/s12871-018-0527-3 |
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