Table 2 Distribution of decannulation recommendations according to clinician and patient scenario characteristics
From: Determinants of tracheostomy decannulation: an international survey
Characteristics | Decannulation recommendation | P valuea | |
|---|---|---|---|
| Â | Yes | No | Â |
| Â | (n = 355) | (n = 320) | Â |
Clinician characteristics | Â | Â | Â |
   Profession |  |  | 0.860 |
Physician | 274 (77) | 245 (77) | Â |
Respiratory therapist | 81 (23) | 75 (23) | Â |
   Time since graduation in years (standard deviation) | 18.9 (9.1) | 18.4 (8.5) | 0.452 |
   Principal work facility |  |  | 0.041 |
Acute care | 282 (79) | 234 (73) | Â |
Weaning | 47 (13) | 52 (16) | Â |
Rehabilitation | 16 (4) | 14 (4) | Â |
Chronic care | 9 (2) | 21 (7) | Â |
   Experience with tracheostomized patients |  |  | 0.349 |
0–5 years | 34 (10) | 44 (14) |  |
6–10 years | 85 (24) | 65 (20) |  |
11–20 years | 134 (38) | 115 (36) |  |
>20 years | 102 (29) | 96 (30) | Â |
   Number of tracheostomy patients cared for per year |  |  | 0.406 |
0–20 patients | 62 (17) | 49 (15) |  |
21–50 patients | 101 (28) | 103 (32) |  |
51–100 patients | 128 (36) | 100 (31) |  |
>100 patients | 64 (18) | 68 (21) | Â |
   Number of tracheostomized patients decannulated per year |  |  | 0.958 |
0–1 patients | 45 (13) | 39 (12) |  |
2–5 patients | 65 (18) | 52 (16) |  |
6–10 patients | 68 (19) | 64 (20) |  |
11–20 patients | 63 (18) | 57 (18) |  |
>20 patients | 114 (32) | 108 (34) | Â |
Patient scenario characteristics | Â | Â | Â |
   Scenario |  |  | 0.707 |
Stroke | 81 (23) | 85 (27) | Â |
Primary respiratory failure | 84 (24) | 75 (23) | Â |
Abdominal aortic aneurysm | 98 (28) | 84 (26) | Â |
Trauma | 92 (26) | 76 (24) | Â |
   Age |  |  | 0.103 |
45 years | 187 (53) | 147 (46) | Â |
75 years | 168 (47) | 173 (54) | Â |
   Comorbidities |  |  | 0.569 |
None | 182 (51) | 157 (49) | Â |
End-stage renal disease | 173 (49) | 163 (51) | Â |
   Etiology of respiratory failure |  |  | 0.030 |
Chronic obstructive pulmonary disease | 192 (54) | 144 (45) | Â |
Pneumonia | 163 (46) | 176 (55) | Â |
   Difficulty of intubation |  |  | 0.089 |
Easy | 190 (54) | 149 (47) | Â |
Difficult | 165 (46) | 171 (53) | Â |
   Level of consciousness |  |  | <0.001 |
Alert and interactive | 248 (70) | 127 (40) | Â |
Drowsy but arousable | 107 (30) | 193 (60) | Â |
   Ability to tolerate capping |  |  | 0.626 |
24 hours | 174 (49) | 163 (51) | Â |
72 hours | 181 (51) | 157 (49) | Â |
   Cough effectiveness |  |  | <0.001 |
Strong cough | 221 (62) | 117 (37) | Â |
Weak cough | 134 (38) | 203 (63) | Â |
   Secretions |  |  | <0.001 |
Scant thin | 196 (55) | 129 (40) | Â |
Moderate thick | 159 (45) | 191 (60) | Â |
   Swallowing function |  |  | <0.001 |
Nil per os | 233 (66) | 262 (82) | Â |
Eating Jell-O and pudding | 122 (34) | 58 (18) | Â |
   Respiratory rate |  |  | 0.129 |
18 breaths per minute | 182 (51) | 146 (46) | Â |
28 breaths per minute | 173 (49) | 174 (54) | Â |
   Oxygenation, 95% saturation |  |  |  |
Fraction of inspired oxygen of 0.30 | 197 (56) | 135 (42) | Â |
Fraction of inspired oxygen of 0.50 | 158 (44) | 185 (58) | 0.001 |