Speech therapy and tracheostomy rehabilitation in COVID 19: five preliminary case reports

Abstract

Studies addressing the hospitalization of patients affected by COVID-19 have reported that length of hospital stay in intensive care unit varies between 12 and 22 days. Part of these patients require orotracheal intubation (OTI) and, in cases where OTI is prolonged and/or with complications, they consequently end up undergoing open surgical tracheostomy (OST). In most hospitals, a multidisciplinary team composed of physicians, nurses, physiotherapists and speech-language therapists is responsible for this process, which allows early removal of the tracheal cannula, making it safer for patients, with reduced risk of failure and complications. Although safety recommendations and procedures support the most diverse protocols of weaning from mechanical ventilation and tracheostomy, there is no universally accepted protocol for this transition. This is a complex issue that is necessary in the current scenario, because studies establishing weaning and decannulation criteria in patients with COVID-19 are urgent at this moment. Purpose: To describe the process of weaning from the tracheostomy in COVID-19 patients. Methods: This is a descriptive study presenting a series of case reports. It describes the decannulation process in five tracheostomized patients with COVID-19 (3 men and 2 women) aged 41 and 74 years who agreed to participate in the study and remained hospitalized in a private hospital in the city of XXXX. Results: The decannulation process of the five COVID-19 patients lasted up to 10 days (mean duration of 6.4 days).