Management of patients with long-term tracheotomies and aspiration.

The purpose of this study was to develop a management protocol for patients with long-term tracheotomies and aspiration, in order to develop clinical criteria for extubation and reduction of aspiration-related complications. We studied 39 patients with tracheotomies in place for over 3 months, 28 of whom completed management. Patients were classified according to degree of impairment and managed with the aims of avoiding aspiration and performing extubation whenever feasible. Criteria for choosing various management strategies are presented.