Indications for tracheostomy and decannulation of tracheostomized ventilator users

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Ventilator users whose airway secretions can be effectively cleared do not require intubation or tracheostomy for ventilatory support, despite possibly having no measurable vital capacity and no significant ventilator-free breathing time (VFBT), Likewise, ventilator users receiving intermittent positive pressure ventilation (IPPV) via an indwelling tracheostomy can be safely decannulated and converted to the use of noninvasive ventilatory support methods provided that a minimum of 3 L.s-1 of peak cough expiratory flow (PCEF) can be achieved by unassisted coughing or by the use of manually- or mechanically-assisted coughing techniques. The use of up to 24 h day-1 noninvasive ventilatory support is preferred by patients and caregivers over tracheostomy IPPV, and is less costly, and appears to be associated with fewer long-term complications.

Original languageEnglish (US)
Pages (from-to)223-227
Number of pages5
JournalMonaldi Archives for Chest Disease
Issue number3
StatePublished - Jan 1 1995
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine


  • Cough
  • Duchenne muscular dystrophy
  • Noninvasive mechanical ventilation
  • Post-poliomyelitis
  • Rehabilitation
  • Spinal cord injury

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