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Journal of Intensive Care Medicine
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Decannulation Following Tracheostomy for Prolonged Mechanical Ventilation

Heidi H. O'Connor, MD

the Pulmonary and Sleep Division, New England Sinai Hospital

Kelly J. Kirby, CTR

the Pulmonary and Sleep Division, New England Sinai Hospital

Norma Terrin, PhD

Institute for Clinical Research and Health Policy Studies

Nicholas S. Hill, MD, FCCP

Division of Pulmonary, Critical Care, and Sleep Medicine Tufts Medical Center, Massachusetts

Alexander C. White, MD, MS

the Pulmonary and Sleep Division, New England Sinai Hospital, awhite{at}nesinai.org

Background: We examined the process of decannulation following tracheostomy in patients transferred to a long-term acute care (LTAC) hospital for weaning from prolonged mechanical ventilation (PMV). Methods: A retrospective chart review of 135 patients. Results: Decannulation was successful in 35% of patients a median of 45 days (IQR, 32-76) following tracheostomy. Patients who failed decannulation had a tracheostomy tube placed earlier (14 days; IQR 11-18 vs. 18 days; IQR 14-30, P = .04) and had a shorter length of stay at the acute facility (20 days; IQR, 16-23 vs. 31 days; IQR, 24-45, P = .003) compared with patients who were decannulated. Length of stay and cost of care at the LTAC did not differ with decannulation status. At 3.5 years, 35% (47/135) of all patients and 62% (29/47) of decannulated patients were alive. Conclusions: Decannulation was achieved in 35% of patients transferred to an LTAC for weaning from prolonged mechanical ventilation.

Key Words: tracheostomy • prolonged mechanical ventilation • weaning • decannulation

This version was published on May 1, 2009

Journal of Intensive Care Medicine, Vol. 24, No. 3, 187-194 (2009)
DOI: 10.1177/0885066609332701
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