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Successful weaning and decannulation after interventional bronchoscopic recanalization of tracheal stenosis.

Abstract：

PURPOSE:Early posttracheostomy tracheal stenosis (PTTS) may cause weaning and decannulation failure. Although bronchoscopic recanalization offers an effective treatment, it is not known how successfully patients can be weaned and decannulated after recanalization. The aims of this study were to determine the incidence of PTTS in a modern weaning center and to elucidate the benefit of interventional recanalization in terms of weaning and decannulation success. MATERIALS AND METHODS:A total of 722 patients admitted within a 24-month period were examined. Patients' baseline characteristics, incidence of weaning and decannulation failure, incidence of PTTS, and rate of postinterventional weaning and decannulation success were determined. RESULTS:Of 722 patients, 450 were deemed suitable for weaning from invasive ventilation. Two hundred eighty-eight patients showed initial weaning and decannulation failure, and 14 of these 288 patients (4.9%) were found to have a PTTS. Recanalization was performed in all cases without procedure-associated complications. Ten (71%) of 14 patients could be successfully weaned and decannulated. Seven of these 10 patients were discharged, 3 patients died during the hospital stay, and 4 (29%) of 14 patients could not be weaned. CONCLUSIONS:Posttracheostomy tracheal stenosis remains a relevant cause of weaning and decannulation failure. Bronchoscopic recanalization is safe and facilitates weaning and successful decannulation in about half of the cases.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Hagmeyer L,Oesterlee U,Treml M,Stieglitz S,Matthes S,Priegnitz C,Randerath W

doi

10.1016/j.jcrc.2014.03.023

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

695.e9-14

issue

4

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(14)00123-3

journal_volume

29

pub_type

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