Heffner J E
St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
J Crit Illn. 1995 Oct;10(10):729-33.
Use the following organized approach to determine whether a patient can be weaned from tracheostomy. Consider airway decannulation only if the original upper airway obstruction has resolved, if mechanical ventilation is no longer needed, and if airway secretions are controlled. Regard the presence of a vigorous cough and the absence of aspiration as additional portents of success. Most critically ill patients benefit from a well-planned, progressive weaning protocol. The tracheostomy button is an ideal weaning device; it maintains the stoma tract and allows the patient to breathe and clear secretions through the upper airway. Monitor the patient for up to 48 hours to ensure tolerance to decannulation.
采用以下有条理的方法来确定患者是否可以从气管造口术中撤机。仅当原来的上气道梗阻已解除、不再需要机械通气且气道分泌物得到控制时，才考虑拔除气管套管。有力咳嗽的存在和无误吸被视为成功的额外征兆。大多数重症患者受益于精心规划的逐步撤机方案。气管造口钮是一种理想的撤机装置；它可维持造口通道，并允许患者通过上气道呼吸和清除分泌物。对患者进行长达48小时的监测，以确保其对拔管的耐受性。
