title: Swallowing disorders in tracheostomised patients: a multidisciplinary/multiprofessional approach in decannulation protocols.
abstract: Safe removal of tracheal cannula is a major goal in the rehabilitation of tracheostomised patients to achieve progressive independence from mechanical support and reduce the risk of respiratory complications. A tracheal cannula may also cause significant discomfort to the patient, making verbal communication difficult. Particularly when cuffed, tracheal cannula reduces the normal movement of the larynx which can further compromise the basic swallowing defect. A close connection between respiratory, phonating, swallowing and feeding abilities to be recovered, implies a strict integration among different professionals of the rehabilitation team. An appropriate management of tracheostomy cannula is closely connected with assessment and treatment of swallowing disorders in order to limit the development of severe pulmonary and nutritional complications, but at present there are no uniform protocols in the scientific literature. Furthermore, several studies report as an essential criterion for decannulation the presence of good patient consciousness, which is often altered in patients with tracheostomy, but a general agreement is lacking.
authors.affiliation: Respiratory Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, I-42015 Correggio, RE, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Garuti
authors.affiliation: Neurological Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, Correggio, RE, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Reverberi
authors.affiliation: Neurological Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, Correggio, RE, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Briganti
authors.affiliation: Respiratory Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, I-42015 Correggio, RE, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Massobrio
authors.affiliation: Respiratory Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, I-42015 Correggio, RE, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lombardi
authors.affiliation: Respiratory Rehabilitation, S. Sebastiano Hospital, AUSL Reggio Emilia, I-42015 Correggio, RE, Italy.
authors.forename: Mirco
authors.initials: M
authors.lastname: Lusuardi
keywords: Dysphagia; Swallowing; Tracheostomy cannula