ArticleFrontiers in neurology
A standardized decannulation protocol improves outcomes in neurorehabilitation of critically ill patients: a quasi-experimental pre-post design.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Purpose: Clinical practice guidelines recommend tracheotomy decannulation protocols for neurorehabilitation of critically ill patients. However, evidence supporting their effectiveness remains limited. This study aimed to analyze the effect of a standardized decannulation protocol on decannulation rates in tracheotomized patients undergoing neurorehabilitation. Methods: Participants were recruited from inpatients in the rehabilitation units of a university-affiliated hospital in Sichuan, China. Tracheotomized patients undergoing neurorehabilitation were assigned to the observation and control groups. The observation group received the standardized decannulation protocol (pre-decannulation assessment, training, preparation, decannulation procedure, and post-decannulation monitoring, ATPPM). This protocol is a multidisciplinary rehabilitation bundle based on the principle of optimizing secretion management. The control group received the routine decannulation protocol (pre-protocol) before the implementation of the new protocol. Outcomes included decannulation rates, the interval from capping to decannulation for metallic tracheotomies, tracheotomy duration, length of stay (LOS), and adverse events. Results: A total of 466 participants were assigned to the control group ( Conclusion: Implementation of the ATPPM decannulation protocol in a specialized, hospital-based neurorehabilitation unit significantly improved decannulation outcomes for inpatients with neurological disorders who were medically stable but tracheotomy-dependent. While these retrospective findings are promising, future prospective studies, randomized controlled trials, are essential to confirm efficacy and control for potential confounding variables.
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