Tracheostomy decannulation: implication on respiratory mechanics.
BACKGROUND
Tracheostomy decreases airway resistance and work of breathing. No comprehensive data are available on respiratory mechanics after tracheostomy decannulation. We evaluated respiratory mechanics after decannulation.


METHODS
Twenty-five patients with tracheostomy were included. Measurement of arterial blood gases, air-flow, and esophageal pressure during spontaneous breathing were evaluated.


RESULTS
Overall arterial blood gas parameters as well as flow and pressure measurements including work of breathing and airway resistance were not affected by the intervention. Inspiratory time fraction increased from 40.0 + or - 0.04 to 43% + or - 0.05% (p = .007). We observed marked individual differences. Postdecannulation change in work of breathing is best predicted by change in airway resistance (R = 0.869, R(2) = 0.755, p < .0001)


CONCLUSIONS
Inspiratory time increased after decannulation, and arterial blood gas levels and respiratory mechanics did not change for the whole cohort. Individual changes in work of breathing are considerable and correlate closely to changes in airway resistance.
Dellweg
Dominic
D
Fachkrankenhaus Kloster Grafschaft, Annostr. 1, 57392 Schmallenberg, Germany. d.dellweg@fkkg.de
Barchfeld
Thomas
T
Haidl
Peter
P
Appelhans
Patrick
P
Kohler
Dieter
D
D000368:Aged; D000403:Airway Resistance; D001784:Blood Gas Analysis; D020878:Device Removal; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D015656:Respiratory Mechanics; D014139:Tracheostomy / Q000295:instrumentation*; D014939:Work of Breathing