ArticleNeurological research and practice2021
Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients - a prospective evaluation.
Article in Neurological research and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
- Treating postextubation dysphagia after stroke with pharyngeal electrical stimulation -insights from a randomized controlled pilot trial.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Trial
- Reliability and validity of the DEFISS score for predicting post-extubation dysphagia and dysphagia-related reintubation after stroke.Scientific reports · 2026Article
- Predictive Factors of Successful Decannulation in Tracheostomy Patients: A Scoping Review.Journal of clinical medicine · 2025Review
- The short-term spinal cord stimulation improves the rates of tracheal decannulation in patients of brain injury with disorders of consciousness.BMC neuroscience · 2025Article
- Decannulation ahead: a comprehensive diagnostic and therapeutic framework for tracheotomized neurological patients.Neurological research and practice · 2025Review
- [Post-Intensive Care Syndrome: functional impairments of critical illness survivors].Die Anaesthesiologie · 2025Review
- Case report: The Montgomery T tube may be the preferred transition option for achieving a smooth extubation after tracheotomy when complicating airway pathology is present.Frontiers in medicine · 2025Article
- A Simplified Protocol for Tracheostomy Decannulation in Patients Weaned off Prolonged Mechanical Ventilation.International archives of otorhinolaryngology · 2024Article
- [Tracheostomy managment and tube weaning within a framework of dysphagia intervention].Der Nervenarzt · 2023Review
- Effect of Modified Pharyngeal Electrical Stimulation on Patients with Severe Chronic Neurogenic Dysphagia: A Single-Arm Prospective Study.Dysphagia · 2023Article
- [Flexible endoscopic evaluation of swallowing in neurology].Der Nervenarzt · 2023Review
- Severe secretion retention: a predictor of decannulation outcome in severe brain injury patients with tracheostomy.European journal of physical and rehabilitation medicine · 2023Article
- Endpoints in Dysphagia Trials. Comment on Speyer et al. Neurostimulation in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analyses of Randomised Controlled Trials-Part I: Pharyngeal and Neuromuscular Electrical Stimulation.Journal of clinical medicine · 2022Article
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundRemoval of a tracheostomy tube in critically ill neurologic patients is a critical issue during intensive care treatment, particularly due to severe dysphagia and insufficient airway protection. The "Standardized Endoscopic Evaluation for Tracheostomy Decannulation in Critically Ill Neurologic Patients" (SESETD) is an objective measure of readiness for decannulation. This protocol includes the stepwise evaluation of secretion management, spontaneous swallowing, and laryngeal sensitivity during fiberoptic endoscopic evaluation of swallowing (FEES). Here, we first evaluated safety and secondly effectiveness of the protocol and sought to identify predictors of decannulation success and decannulation failure.
methodsA prospective observational study was conducted in the neurological intensive care unit at Münster University Hospital, Germany between January 2013 and December 2017. Three hundred and seventy-seven tracheostomized patients with an acute neurologic disease completely weaned from mechanical ventilation were included, all of whom were examined by FEES within 72 h from end of mechanical ventilation. Using regression analysis, predictors of successful decannulation, as well as decannulation failure were investigated.
resultsTwo hundred and twenty-seven patients (60.2%) could be decannulated during their stay according to the protocol, 59 of whom within 24 h from the initial FEES after completed weaning. 3.5% of patients had to be recannulated due to severe dysphagia or related complications. Prolonged mechanical ventilation showed to be a significant predictor of decannulation failure. Lower age was identified to be a significant predictor of early decannulation after end of weaning. Transforming the binary SESETD into a 4-point scale helped predicting decannulation success in patients not immediately ready for decannulation after the end of respiratory weaning (optimal cutoff ≥1; sensitivity: 64%, specifity: 66%).
conclusionsThe SESETD showed to be a safe and efficient tool to evaluate readiness for decannulation in our patient collective of critically ill neurologic patients.
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