title: Sequential invasive-noninvasive mechanical ventilation weaning strategy for patients after tracheostomy.
abstract: BACKGROUND
  Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy.
  
  
  METHODS
  Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups.
  
  
  RESULTS
  Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased.
  
  
  CONCLUSIONS
  Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.
authors.affiliation: Department of Geriatric Pulmonary Diseases, Anhui Geriatric Institute, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Xue-Xue
authors.initials: XX
authors.lastname: Pu
authors.affiliation: Department of Geriatric Pulmonary Diseases, Anhui Geriatric Institute, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Jiong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Geriatric Pulmonary Diseases, Anhui Geriatric Institute, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Xue-Bo
authors.initials: XB
authors.lastname: Yan
authors.affiliation: Department of Geriatric Pulmonary Diseases, Anhui Geriatric Institute, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
authors.forename: Xue-Qin
authors.initials: XQ
authors.lastname: Jiang
keywords: Respiratory failure; Sequential invasive-noninvasive ventilation; Tracheostomy; Weaning