EN
TÜRKÇE
Oral Presentation - 4
Use a decanulation protocol in the pediatric population
MM Urquizo Lino, J Camacho
Department of Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Aim
To report the results of our decannulation protocol performed by the aerodigestive team of the Italian Hospital of Buenos Aires.
Methodology
Retrospective study from 2014 to 2024 of 385 tracheostomized patients, in which the decannulation protocol (CP) was applied by an interdisciplinary team.
In 2014, we implemented a guided decannulation evaluation protocol in patients who had been successfully weaned from prolonged mechanical ventilation, which consisted of 3 parts: 1. Daily evaluation of the need for tracheostomy 2. Measurement of subglottic pressure, decreasing the diameter of the cannula and use of a speaking valve 3. Endoscopic evaluation of the airway, occlusion test according to age and decannulation. Main variable: days of use of the tracheostomy cannula, from the day of surgery to the day of decannulation.
Results
254 children achieved decannulation and were recruited consecutively, from a total of 385 patients tracheostomized in that period. The median age was 30 months, (1-228); the diagnosis of admission was respiratory cause 20% CI 95% (10-35), cardiovascular 15% CI 95% (7-30), neurological 17.5% CI 95% (8-33) and other causes 47.5% CI 95% (32-63). The surgical procedure was percutaneous in 10%, while 90% was open with the Björk technique. A vidobronchoscopy was performed in all cases. The average use of the tracheostomy cannula was 46 days with an IQR (29-144). In the CP group a median of 33 days with CI 95 5 (23-44) obtaining a p 0.0012.
Conclusion
The use of a decannulation protocol applied by an interdisciplinary work team showed a significant decrease in the days of use of tracheostomy cannulas in pediatric patients weaned from respiratory assistance