Calderone Andrea, Filoni Serena, De Luca Rosaria, Corallo Francesco, Calapai Rosalia, Mirabile Alessio, Caminiti Fabrizia, Conti-Nibali Valeria, Quartarone Angelo, Calabrò Rocco Salvatore, Rifici Carmela
IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy.
Unit of Neuro-Rehabilitation, IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
J Clin Med. 2025 May 28;14(11):3798. doi: 10.3390/jcm14113798.
: Tracheostomy (TCT) creates an artificial airway, essential for overcoming obstructions or enabling long-term ventilation. Decannulation represents a critical step in recovery, with its success strongly influenced by the underlying indication for tracheostomy and the patient's clinical profile. Successful decannulation requires careful assessment of multiple factors, including respiratory function and underlying pathology. This scoping review aims to identify and categorize these predictive factors, crucial for optimizing decannulation protocols and patient outcomes. : A scoping review was conducted using the PubMed, Web of Science, Cochrane Library, Embase, EBSCOhost, and Scopus databases (22 February 2025-3 March 2025) to identify studies regarding predictors of successful decannulation. Studies examining physiological, clinical, and demographic factors associated with decannulation outcomes were included. Data were extracted using a standardized form and synthesized narratively. : Fifty studies reported a male representation averaging 67% of the total patient population, comprising 2238 males and 1281 females aged 50-70 with acquired brain injuries, employing retrospective and prospective designs. Positive decannulation outcomes correlate with strong cough, effective secretion management, younger age, and robust neurological status. Adverse events were generally mild, with recannulation being infrequent. Conversely, advanced age, chronic lung disease, a high body mass index, and prolonged mechanical ventilation negatively influence decannulation success. : It was highlighted that successful decannulation is the result of various physiological, clinical, and demographic factors. Significantly, strong respiratory function, demonstrated by powerful cough reflexes and efficient secretion control, stands out as a fundamental predictive factor.
气管切开术(TCT)可建立人工气道,这对于克服气道阻塞或实现长期通气至关重要。拔管是康复过程中的关键步骤,其成功与否受到气管切开术的潜在指征和患者临床状况的强烈影响。成功拔管需要仔细评估多个因素,包括呼吸功能和潜在病理情况。本范围综述旨在识别并分类这些预测因素,这对于优化拔管方案和患者预后至关重要。
使用PubMed、科学网、考克兰图书馆、Embase、EBSCOhost和Scopus数据库(2025年2月22日至2025年3月3日)进行了一项范围综述,以识别关于成功拔管预测因素的研究。纳入了研究与拔管结果相关的生理、临床和人口统计学因素的研究。使用标准化表格提取数据并进行叙述性综合分析。
五十项研究报告称,男性占患者总数的平均比例为67%,包括2238名男性和1281名年龄在50至70岁之间、患有获得性脑损伤的女性,采用回顾性和前瞻性设计。拔管成功的结果与强烈咳嗽、有效的分泌物管理、较年轻的年龄和良好的神经状态相关。不良事件一般较轻,再次插管的情况很少见。相反,高龄、慢性肺病、高体重指数和长时间机械通气对拔管成功有负面影响。
强调指出,成功拔管是多种生理、临床和人口统计学因素的结果。值得注意的是,由强烈咳嗽反射和有效分泌物控制所证明的强大呼吸功能是一个基本的预测因素。