Tracheostomy Decannulation: Key Practical Aspects

Absence of distress and stable ABG values on prolonged mechanical ventilation for 5 days

Stable clinical conditions (hemodynamic stability, absence of fever or active infection)

PaCO₂ < 60 mmHg

Normal endoscopic examination or revealing stenotic lesions occupying <30 % of the airways

Adequate swallowing evaluated by gag reflex, blue dye, and video fluoroscopy

MEP >40 cmH₂O or PCF > 160 l/min (NMD patients)

Tube capping >24 h

ABG arterial blood gases, PaCO ₂partial pressure of carbon dioxide, MEP maximum expiratory pressure, PCF peak cough flow

In conclusion, decannulation is usually well tolerated by the patient, but a systematic approach to patient evaluation is needed. Following decannulation, patients require close monitoring to identify signs of airway compromise.

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