Related Experiment Video
Updated: May 28, 2025
A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
RETROSPECTIVE ANALYSIS OF PATIENTS WITH IMMEDIATE DECANNULATION IN SEVERE ACQUIRED BRAIN INJURY (RAPID-SABI)
Robbert-Jan VAN Hooff1, Mette Lindelof1, Emma Ghaziani1
1Department of Brain and Spinal Cord Injury, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Objective:
To examine an early decannulation protocol in adult severe acquired brain injury (SABI) patients.
Design:
Retrospective, observational cohort study.
Subjects/Patients:
Tracheotomized SABI patients ≥ 18 years admitted to a neurorehabilitation unit.
Methods:
Primary outcome measure was difference in survival rate within first year of discharge. Secondary outcome measures were respiratory infections treated with antibiotics, rate of re-cannulation, time from admission to decannulation, length of stay, difference in rate of re-admission due to pneumonia within first year of discharge and difference in rate of tracheal tube dependency within first year of discharge.
Results:
No statistical significance in survival rate within the first 12 months from discharge was found. Median time from admission to decannulation was 32 days (interquartile range [IQR] 14-61) vs 9 days (IQR 0-13) in the control and intervention group, respectively (p < 0.0003). Median length of stay was 66 days (IQR 54-92) in the control group vs 60 (IQR 48-75) days in the intervention group (p = 0.168).
Conclusion:
A new early decannulation protocol omitting evaluation of tolerance to tracheostomy tube capping and fiberoptic endoscopic evaluation of swallowing was non-inferior to previous procedures in survival rate within first year of discharge. The early decannulation protocol allowed for significantly earlier decannulation.
