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首页> 美国卫生研究院文献>International Archives of Otorhinolaryngology >Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after severe Acquired Brain Injury (sABI)
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Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after severe Acquired Brain Injury (sABI)

机译：重度后天性脑损伤（sABI）后接受康复治疗的患者气管造口术脱气的参数

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>Introduction  Tracheostomy weaning in patients who suffered a severe acquired brain injury is often a challenge and decannulation failures are not uncommon. >Objective  Our study objective is to describe the decannulation failure rate in patients undergoing rehabilitation following a severe acquired brain injury (sABI); to describe the factors associated with a successful tube weaning. >Methods  We conduct a retrospective analysis of charts, consecutively retrieved considering a 3-year window. Variables analyzed were: age, sex, body mass index (BMI), Glasgow Coma Scale (GCS), cause of hospitalization (stroke, trauma, cardiac arrest), date of the pathological event, gap between the index event and the first day of hospitalization, duration of Neurorehabilitation Ward hospitalization, comorbidities, chest morphological alteration, kind of tracheostomy tube used (overall dimension, cap, fenestration), SpO2, presentation and quantification of pulmonary secretion, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respiratory frequency and pattern, cardiac frequency, presence of spontaneous cough, cough strength, and blood gas analysis. >Results  We analyzed 45 tracheostomised sABI patients following stroke, trauma, or cardiac arrest. The weaning success percentage was higher in Head Trauma patients and in patients presenting positive spontaneous cough. Failures seem to be associated with presence of secretions and anoxic brain damage. GCS seemed not related to the decannulation outcome. >Conclusions  Parameters that could be used as positive predictors of weaning are: mean expiratory pressure, presence of spontaneous cough, and cough strength. Provoked cough and GCS were not predictive of weaning success.
机译：>简介 in对于患有严重后天性脑损伤的患者，气管切开术断奶通常是一个挑战，而脱气管失败并不罕见。 >目的我们的研究目的是描述严重后天性脑损伤（sABI）后接受康复治疗的患者的脱椎失败率；描述与成功进行断奶相关的因素。 >方法我们对图表进行回顾性分析，并考虑3年的时间范围连续检索。分析的变量包括：年龄，性别，体重指数（BMI），格拉斯哥昏迷量表（GCS），住院原因（中风，外伤，心脏骤停），病理事件的日期，指数事件与发病的第一天之间的差距住院，神经康复病房的住院时间，合并症，胸部形态改变，使用的气管造口管种类（整体尺寸，顶盖，开窗），SpO2，肺分泌物的表现和定量，最大吸气压力（MIP）和最大呼气压力（MEP） ，呼吸频率和模式，心脏频率，是否存在自发性咳嗽，咳嗽强度和血气分析。 >结果我们分析了45例中风，外伤或心脏骤停后经气管切开的sABI患者。头部创伤患者和自发阳性咳嗽患者的断奶成功率更高。失败似乎与分泌物的存在和缺氧性脑损伤有关。 GCS似乎与脱皮的结果无关。 >结论可以用作断奶的积极预测指标的参数包括：平均呼气压力，是否存在自发性咳嗽和咳嗽强度。引起的咳嗽和GCS不能预示断奶成功。

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