Influência da força da musculatura periférica no sucesso da decanulação

Decanulação: indicadores sociodemográficos, clínicos e fonoaudiológicos preditivos de sucesso

“…Presence of abundant secretions and need for frequent tracheal aspirations in a 24-hour period are considered contraindications to decannulation (13,16) . It is worth emphasizing that cuff deflation favors better functionality of the larynx, thus allowing airflow through the upper airway, improved laryngeal elevation and sensitivity, removal of lung secretions, protection of the lower airways, voice, and deglutition.…”

“…Among the individuals who did not show abundant secretions, it was observed that the chance of success in decannulation was 28.6 fold that of those who had these secretions. Presence of abundant secretions and need for frequent aspirations over a 24-hour period are causes of contraindications for decannulation (13,16) . It is known that the presence of inflated cuff does not prevent the aspiration of saliva, but its use minimizes macro-aspiration (6,13,21) .…”

“…The following criteria are suggested for indication and success in decannulation: ability to tolerate cuff deflation for 24h (9,10) ; presence of respiratory muscle strength and resistance (11,12) ; effective cough with ability to remove lung secretions (7,(9)(10)(11)(13)(14)(15) ; voluntary and reflexive cough (7,10,11,13) ; intact upper airways (5,9,13,15) ; absence of glottic or subglottic stenosis (16,17) ; preserved swallowing capacity (7,9,(11)(12)(13)(15)(16)(17) ; performance of the Blue Dye test (6,11,13,18) ; absence of previous head and neck surgery (7,11) ; use of phonation valve (11,14) ; tolerance to tracheostomy occlusion, with or without need for oxygen therapy (9,11,12,15,17) ; stable oxygen saturation for longer than 24h after tube occlusion (7,(9)(10)(11)…”