Tracheostomy decannulation in severe acquired brain injury patients: The role of flexible bronchoscopy

Barbara Lanini, Barbara Binazzi, Isabella Romagnoli, Elisa Chellini, Lucrezia Pianigiani, Ariela Tofani, Raffaele Molino Lova, Lorenzo Corbetta, Francesco Gigliotti

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and objectives: Subjects with severe acquired brain injury (sABI) require long-term mechanical ventilation and, as a consequence, the tracheostomy tube stays in place for a long time. In this observational study, we investigated to what extent the identification of late tracheostomy complications by flexible bronchoscopy (FBS) might guide clinicians in the treatment of tracheal lesions throughout the weaning process and lead to successful decannulation. Subjects and methods: One hundred and ninety-four subjects with sABI admitted to our rehabilitation unit were enrolled in the study. All subjects received FBS and tracheal lesions were treated either by choosing a more suitable tracheostomy tube, or by laser therapy, or by steroid therapy, or by a combination of the above treatments. Results: Overall, 122 subjects (63%) were decannulated successfully. Our subjects received 495 FBSs (2.55 per subject) and as many as 270 late tracheostomy complications were identified. At least one complication was found in 160 subjects (82%). In only 11 subjects, late tracheostomy complications did not respond to the treatment and were the cause of decannulation failure. Conclusions: In conclusion, in sABI patients FBS is able to guide successful tracheostomy weaning in the presence of late tracheostomy complications that could get in the way decannulation.

Original languageEnglish
JournalPulmonology
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Acquired brain injuries
  • Decannulation
  • Flexible bronchoscopy
  • Late tracheostomy complications

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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