title: Tracheostomy decannulation.
abstract: Tracheostomy tubes are placed for a variety of reasons, including failure to wean from mechanical ventilation, inability to protect the airway due to impaired mental status, inability to manage excessive secretions, and upper-airway obstruction. A tracheostomy tube is required in approximately 10% of patients receiving mechanical ventilation and allows the patient to move to a step-down unit or long-term care hospital. The presence of a tracheostomy tube in the trachea can cause complications, including tracheal stenosis, bleeding, infection, aspiration pneumonia, and fistula formation from the trachea to either the esophagus or the innominate artery. Final removal of the tracheostomy tube is an important step in the recovery from chronic critical illness and can usually be done once the indication for the tube placement has resolved.
authors.affiliation: Department of Pulmonary and Sleep Medicine, Rose Kalman Research Center, New England Sinai Hospital, 150 York Street, Stoughton, MA 02072, USA. hoconnor@nesinai.org
authors.forename: Heidi H
authors.initials: HH
authors.lastname: O'Connor
authors.forename: Alexander C
authors.initials: AC
authors.lastname: White
mesh_terms: D016638:Critical Illness / Q000628:therapy; D020878:Device Removal; D006801:Humans; D011175:Positive-Pressure Respiration; D014139:Tracheostomy; D015300:Ventilator Weaning