Protocolos de decanulação: uma revisão de literatura

Abstract

Introduction: Tracheostomy is probably the most common surgical procedure performed on critically ill patients, that which made an opening and externalization of the tracheal lumen. Studies have confirmed the benefit of tracheostomy weaning protocols and participation of physical therapists in this process, but there is still no consensus on criteria for decannulation. Objective: To determine, through literature review, the criteria more indicated and done in the process of decannulation of patients. Methods: Were conducted searches in Medline / Pubmed, Lilacs and SciELO, the period from 2002 to 2012. The keywords, in Portuguese and English, used in the search were: tracheostomy, decannulation, decannulations criteria, decannulations protocols, and physiotherapy. To be included, studies should investigate the criteria used in the process of decannulation in tracheostomized adult patients. Results: Were included eight articles to achieve the revised narrative in question; two assessed the patient's level of consciousness, cough effectiveness, secretions and ability to tolerate occlusion of TQT for 24 hours; five rated the cough peak flow, muscle training (MIP, MEP) and one evaluated bronchoscopy as a criterion for decannulation. Conclusion: Further studies are needed to compare the various techniques decannulation prove its effectiveness and ensure the safety of the procedure favoring the complete rehabilitation of the patient.