Retrospective analysis of patients with immediate decannulation in severe acquired brain injury (RAPID-SABI)

Objective: To examine an early decannulation protocol in adult severe acquired brain injury (SABI) patients. Design: Retrospective, observational cohort study. Subjects/patients: Tracheotomized SABI patients ≥ 18 years admitted to a neurorehabilitation unit. Methods: Primary outcome measure was d...

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Main Authors: Robbert-Jan van Hooff, Mette Lindelof, Emma Ghaziani, Trine Hørmann Thomsen, Christina Kruuse, Christian Gunge Riberholt, Charlotte Rath
Format: Article
Language:English
Published: Medical Journals Sweden 2025-02-01
Series:Journal of Rehabilitation Medicine - Clinical Communications
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Online Access:https://medicaljournalssweden.se/jrm-cc/article/view/42068
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Summary:Objective: To examine an early decannulation protocol in adult severe acquired brain injury (SABI) patients. Design: Retrospective, observational cohort study. Subjects/patients: Tracheotomized SABI patients ≥ 18 years admitted to a neurorehabilitation unit. Methods: Primary outcome measure was difference in survival rate within first year of discharge. Secondary outcome measures were respiratory infections treated with antibiotics, rate of re-cannulation, time from admission to decannulation, length of stay, difference in rate of re-admission due to pneumonia within first year of discharge and difference in rate of tracheal tube dependency within first year of discharge. Results: No statistical significance in survival rate within the first 12 months from discharge was found. Median time from admission to decannulation was 32 days (interquartile range [IQR] 14–61) vs 9 days (IQR 0–13) in the control and intervention group, respectively (p < 0.0003). Median length of stay was 66 days (IQR 54–92) in the control group vs 60 (IQR 48–75) days in the intervention group (p = 0.168). Conclusion: A new early decannulation protocol omitting evaluation of tolerance to tracheostomy tube capping and fiberoptic endoscopic evaluation of swallowing was non-inferior to previous procedures in survival rate within first year of discharge. The early decannulation protocol allowed for significantly earlier decannulation.
ISSN:2003-0711