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    The role of non-invasive ventilation in weaning and decannulating critically ill patients with tracheostomy: A narrative review of the literature

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    Author
    Guia, Miguel
    Ciobanu, Laura D.
    Sreedharan, Jithin K.
    Abdelrahim, Mohamed E.
    Gonçalves, Gil
    Cabrita, Bruno
    Alqahtani, Jaber S.
    Duan, Jun
    El-Khatib, Mohamad
    Diaz-Abad, Montserrat
    Wittenstein, Jakob
    Karim, Habib M.R.
    Bhakta, Pradipta
    Ruggeri, Paolo
    Garuti, Giancarlo
    Burns, Karen E.A.
    Soo Hoo, Guy W.
    Scala, Raffaele
    Esquinas, Antonio
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    Date
    2020-07-25
    Journal
    Pulmonology
    Publisher
    Elsevier Ltd.
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.pulmoe.2020.07.002
    Abstract
    Introduction: Invasive mechanical ventilation (IMV) is associated with several complications. Placement of a long-term airway (tracheostomy) is also associated with short and long-term risks for patients. Nevertheless, tracheostomies are placed to help reduce the duration of IMV, facilitate weaning and eventually undergo successful decannulation. Methods: We performed a narrative review by searching PubMed, Embase and Medline databases to identify relevant citations using the search terms (with synonyms and closely related words) “non-invasive ventilation”, “tracheostomy” and “weaning”. We identified 13 publications comprising retrospective or prospective studies in which non-invasive ventilation (NIV) was one of the strategies used during weaning from IMV and/or tracheostomy decannulation. Results: In some studies, patients with tracheostomies represented a subgroup of patients on IMV. Most of the studies involved patients with underlying cardiopulmonary comorbidities and conditions, and primarily involved specialized weaning centres. Not all studies provided data on decannulation, although those which did, report high success rates for weaning and decannulation when using NIV as an adjunct to weaning patient off ventilatory support. However, a significant percentage of patients still needed home NIV after discharge. Conclusions: The review supports a potential role for NIV in weaning patients with a tracheostomy either off the ventilator and/or with its decannulation. Additional research is needed to develop weaning protocols and better characterize the role of NIV during weaning.
    Keyword
    Decannulation
    Non-invasive ventilation
    Tracheostomy
    Ventilator weaning
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13489
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.pulmoe.2020.07.002
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    UMB Open Access Articles 2020

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