From the Department of Cardiorespiratory Rehabilitation, Universidad Nacional de Asunción-Facultad de Ciencias Médicas, Hospital de Clinicas, San Lorenzo, Paraguay (GCG, MM-T); Department of Pediatrics, Universidad de Chile, Hospital Clínico San Borja Arriarán, Santiago, Chile (FJP); and Department of Physical Medicine and Rehabilitation, Rutgers University-New Jersey Medical School, Newark, New Jersey (JRB).
Am J Phys Med Rehabil. 2021 Aug 1;100(8):730-732. doi: 10.1097/PHM.0000000000001788.
A 66-yr-old man had been intubated for 21 days for severe COVID-19 infection. He then underwent tracheotomy, retained the tube for 2 mos, and then was discharged home on 10 liters of O2/min breathing via a tracheostomy collar. We were consulted for tracheostomy tube decannulation. Mechanical insufflation-exsufflation was used via the tracheostomy tube to clear secretions, increase vital capacity, and normalize O2 saturation. He practiced nasal and mouthpiece noninvasive ventilatory support once a capped fenestrated cuffless tracheostomy tube was placed, although he did not need noninvasive ventilatory support after decannulation. He was decannulated despite O2 dependence. Although he required antibiotics for almost 3 mos before decannulation and after it, he had no further episodes of lung infection for at least the next 4 mos from the point of decannulation.
一位 66 岁的男性因严重的 COVID-19 感染而插管 21 天。随后，他接受了气管切开术，保留了管子 2 个月，然后在通过气管造口套管以 10 升/分钟的氧气呼吸的情况下出院回家。我们被咨询有关气管切开管拔管的问题。通过气管切开管使用机械通气-呼气来清除分泌物、增加肺活量并使氧饱和度正常化。在放置带帽无囊气管切开管后，他练习了鼻和口罩无创通气支持，尽管在拔管后他不需要无创通气支持。尽管他依赖氧气，但仍进行了拔管。尽管他在拔管前和拔管后几乎需要抗生素治疗 3 个月，但从拔管之日起至少在接下来的 4 个月内，他没有再次发生肺部感染。
