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The evaluation of physiologic decannulation readiness according to upper airway resistance measurement
Chunli Gao1, Liang Zhou, Chunsheng Wei
1Shanghai Eye and ENT Hospital, Fudan University, Shanghai, China.
Objective:
To measure the upper-airway resistance in patients with tracheostomies and determine the value representing decannulation readiness.
Subjects And Methods:
Fifty-six patients with tracheostomies resultant to laryngeal disease participated in this study. Forty patients met clinical criteria for decannulation; 16 did not. Subglottal pressure was measured with a tube connected to the tracheostomy tube, and airflow was monitored simultaneously using a facemask. Upper-airway resistance measurements were recorded during shallow and deep breathing.
Results:
During both shallow and deep breathing, the inspiratory and expiratory resistances were significantly higher for the group unsuitable for decannulation (P < .0001). The areas under the receiver operating characteristic curves were 0.938 or greater for the four curves, indicating a high sensitivity and specificity of resistance measures for diagnosis.
Conclusions:
Objective measurement of upper-airway resistance during shallow and deep breathing may be a useful parameter in determining decannulation readiness of tracheostomized patients.
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