Estudo preliminar sobre a proposta de um fluxograma de decanulação em traqueostomia com atuação interdisciplinar Preliminary study on a proposal of an interdisciplinary flowchart of tracheostomy decannulation
2008
objective: To evaluate the weaning steps of decanulation in patients admitted at the Semi-intensive Care Unit of the Hospital Israelita Albert Einstein, following a protocol proposed and developed by Physical Therapy and Phonoaudiology specialists, with a focus on interdisciplinary actions and also to analyze the values of ventilatory measurements, weaning complications and the relation between success and decanulation mean time. Methods: A weaning and decanulation flowchart was applied to a population of 21 tracheostomized patients with several clinical diagnoses. All patients met the basic criteria for the weaning procedure. Maximum inspiratory pressure (MIP), maximum expiratory (MEP), vital capacity and peak cough flow data were analyzed. results: In the population subject of this study, patients presented an average peak cough flow value of 174.74 l/min in the beginning of the weaning, standard deviation = 58.03, with a lower value of 80 and higher of 310 l/min. All patients who were decanulated presented MIP > -30cmH 2 O. In this preliminary study, the MEP and the MIP measure have not demonstrated to be an effective measure for the sake of data analysis as success predictors. Conclusions: This study revealed that the weaning and decanulation of tracheomatized patients is more efficient and safer when there is an interdisciplinary participation and that available data are still at a preliminary stage and they point out the need of further studies over a larger population.
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