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

Abstract

To measure the upper-airway resistance in patients with tracheostomies and determine the value representing decannulation readiness. 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. 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. Objective measurement of upper-airway resistance during shallow and deep breathing may be a useful parameter in determining decannulation readiness of tracheostomized patients.