The role of non-invasive ventilation in weaning and decannulating critically ill patients with tracheostomy: A narrative review of the literature

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Miguel Guia - , Hospital Professor Doutor Fernando Fonseca (Author)
  • Laura D. Ciobanu - , Grigore T. Popa University of Medicine and Pharmacy (Author)
  • Jithin K. Sreedharan - , Prince Sultan Military College of Health Sciences - Dhahran (Author)
  • Mohamed E. Abdelrahim - , Beni-Suef University (Author)
  • Gil Gonçalves - , University of Coimbra (Author)
  • Bruno Cabrita - , Hospital Pedro Hispano (Author)
  • Jaber S. Alqahtani - , Prince Sultan Military College of Health Sciences - Dhahran (Author)
  • Jun Duan - , Chongqing Medical University (Author)
  • Mohamad El-Khatib - , American University of Beirut (Author)
  • Montserrat Diaz-Abad - , University of Maryland, Baltimore (Author)
  • Jakob Wittenstein - , Department of Anesthesiology and Intensive Care Medicine (Author)
  • Habib M.R. Karim - , All India Institute of Medical Sciences, Raipur (Author)
  • Pradipta Bhakta - , University College Cork (Author)
  • Paolo Ruggeri - , University of Messina (Author)
  • Giancarlo Garuti - , Azienda USL di Modena (Author)
  • Karen E.A. Burns - , University of Toronto (Author)
  • Guy W. Soo Hoo - , Department of Veterans Affairs (Author)
  • Raffaele Scala - , IRCCS Policlinico San Donato (Author)
  • Antonio Esquinas - , Hospital Morales Meseguer (Author)

Abstract

Introduction: Invasive mechanical ventilation (IMV) is associated with several complications. Placement of a long-term airway (tracheostomy) is also associated with short and long-term risks for patients. Nevertheless, tracheostomies are placed to help reduce the duration of IMV, facilitate weaning and eventually undergo successful decannulation. Methods: We performed a narrative review by searching PubMed, Embase and Medline databases to identify relevant citations using the search terms (with synonyms and closely related words) “non-invasive ventilation”, “tracheostomy” and “weaning”. We identified 13 publications comprising retrospective or prospective studies in which non-invasive ventilation (NIV) was one of the strategies used during weaning from IMV and/or tracheostomy decannulation. Results: In some studies, patients with tracheostomies represented a subgroup of patients on IMV. Most of the studies involved patients with underlying cardiopulmonary comorbidities and conditions, and primarily involved specialized weaning centres. Not all studies provided data on decannulation, although those which did, report high success rates for weaning and decannulation when using NIV as an adjunct to weaning patient off ventilatory support. However, a significant percentage of patients still needed home NIV after discharge. Conclusions: The review supports a potential role for NIV in weaning patients with a tracheostomy either off the ventilator and/or with its decannulation. Additional research is needed to develop weaning protocols and better characterize the role of NIV during weaning.

Details

Original languageEnglish
Pages (from-to)43-51
Number of pages9
JournalPulmonology
Volume27
Issue number1
Publication statusPublished - 1 Jan 2021
Peer-reviewedYes

External IDs

PubMed 32723618
ORCID /0000-0003-4397-1467/work/142238070

Keywords

ASJC Scopus subject areas

Keywords

  • Decannulation, Non-invasive ventilation, Tracheostomy, Ventilator weaning