TY - JOUR T1 - Decannulation of tracheostomized patients JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA3715 VL - 46 IS - suppl 59 SP - PA3715 AU - Daniela Alves AU - Inês Faria AU - Carvalheira Santos AU - Rosa Silva AU - Cristina Bárbara Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA3715.abstract N2 - The decannulation of tracheostomized patients admitted to an intermediate care unit (ICU) mainly occurs when the weaning of patients with prolonged mechanical ventilation (PMV) fails or when there is inability to protect the airway. The following criteria should be assessed: clinical status, spontaneous breathing, effective cough and absence of glottis dysfunction. The authors describe a retrospective study of tracheostomized patients admitted to the ICU during the last 5years that showed difficulty in decannulation. We identified 42 patients, 64%male, with an average age of 64years old. The majority of them, 55%had respiratory disease (COPD29% and tuberculosis sequelae7%). Of all patients, 79%were tracheotomized after PMV, having remained, on average, 51days under PMV. The main reasons for tracheostomy were respiratory tract infection31%, septic shock29%, laryngeal neoplasia19%, neuromuscular7% and neurological pathologies7% and others7%. In 26% of patients tracheostomy was definitive. Of the 31patients that underwent protocol decannulation, 15 were successfully decannulated(48%). The average of days to decannulation was 72. On the 16 patients on which decannulation was not possible, the causes were: ineffective cough44%, glottis dysfunction37%, express will of the patient12%, tracheal stenosis6% and others19%. It should also be noted that these patients had multiple comorbidities, namely: hypertension47%, psychiatric disease26%, diabetes23%. After being discharged from the ICU, 45%became outpatients and 14%were admitted in long-term care units. The results show the need for special care, which reflects in the costs. These cases are clinically challenging and success is based on the rigorous application of the above criteria. ER -