Decannulation protocol in pediatric patients: case series study

Rev Paul Pediatr. 2024 Sep 23:43:e2023187. doi: 10.1590/1984-0462/2025/43/2023187. eCollection 2024.

Abstract

Objective: The aim of this study was to describe the phases of a decannulation protocol and the results from its application in hospitalized children.

Methods: This is a retrospective, observational study. Data were collected from medical records of decannulated patients followed up in a pediatric hospital in Belo Horizonte, Minas Gerais between 2011 and 2021.

Results: Among the children followed up in the service (n=526), 23% (n=120) were successfully decannulated. Children aged between 2 months and 16 years, with a mean age of 4 years, 69% of whom were male, were evaluated. About 75% of the patients have tracheostomy due to upper airway obstruction and 60% of these due to acquired subglottic stenosis. At the beginning of the decannulation protocol, 5.5% of the patients had moderate oropharyngeal dysphagia, while 80.4% had normal swallowing. Correction in the upper airway pre-decannulation was performed in 39.5% of the patients, dilation in 63.8%, and endoscopic correction was performed in 55.3%. After performing the decannulation, none of the patients had complications.

Conclusions: The described decannulation protocol is safe, since no complications such as death and need for recannulation happened.

Objetivo:: Descrever as etapas de um protocolo de decanulação e os resultados da aplicação desse protocolo em crianças hospitalizadas.

Métodos:: Trata-se de um estudo observacional retrospectivo. Os dados foram coletados de prontuários de pacientes decanulados acompanhados em um hospital pediátrico de Belo Horizonte, Minas Gerais, entre 2011 e 2021.

Resultados:: Foram analisadas 120 crianças com idade entre dois meses e 16 anos, com média de idade de quatro anos, 69% das quais eram do sexo masculino. Cerca de 75% dos pacientes apresentam traqueostomia por obstrução de vias aéreas superiores e 60% destes por estenose subglótica adquirida. No início do protocolo de decanulação, 5,5% dos pacientes apresentavam disfagia orofaríngea moderada, enquanto 80,4% apresentavam deglutição normal. A correção da pré-decanulação das vias aéreas superiores foi realizada em 39,5% dos pacientes, a dilatação em 63,8% e a correção endoscópica em 55,3%. Após a realização da decanulação, nenhum paciente apresentou complicações.

Conclusões:: O protocolo de decanulação descrito é seguro, pois a taxa de complicações como óbito e a necessidade de recanulação foi ausente.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Airway Obstruction / etiology
  • Airway Obstruction / surgery
  • Child
  • Child, Preschool
  • Clinical Protocols
  • Deglutition Disorders / etiology
  • Device Removal* / methods
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Tracheostomy* / adverse effects
  • Tracheostomy* / methods