The evaluation of physiologic decannulation readiness according to upper airway resistance measurement.

Abstract

OBJECTIVE:

To measure the upper-airway resistance in patients with tracheostomies and determine the value representing decannulation readiness.

SUBJECTS AND METHODS:

Fifty-six patients with tracheostomies resultant to laryngeal disease participated in this study. Forty patients met clinical criteria for decannulation; 16 did not. Subglottal pressure was measured with a tube connected to the tracheostomy tube, and airflow was monitored simultaneously using a facemask. Upper-airway resistance measurements were recorded during shallow and deep breathing.

RESULTS:

During both shallow and deep breathing, the inspiratory and expiratory resistances were significantly higher for the group unsuitable for decannulation (P < .0001). The areas under the receiver operating characteristic curves were 0.938 or greater for the four curves, indicating a high sensitivity and specificity of resistance measures for diagnosis.

CONCLUSIONS:

Objective measurement of upper-airway resistance during shallow and deep breathing may be a useful parameter in determining decannulation readiness of tracheostomized patients.

• Authors: Chunli Gao, Liang Zhou, Chunsheng Wei, Matthew R Hoffman, Cai Li, Jack J Jiang
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 139 Issue 4 Pg. 535-40 (Oct 2008) ISSN: 0194-5998 [Print] England
• PMID: 18922340 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Airway Resistance (physiology)
• Area Under Curve
• Device Removal
• Female
• Humans
• Laryngeal Diseases (physiopathology, surgery)
• Male
• Middle Aged
• ROC Curve
• Respiratory Function Tests (instrumentation)
• Respiratory Mechanics
• Sensitivity and Specificity
• Tracheostomy