Tracheostomy Clinical Trial
Official title:
Feasibility and Safety of Immediate Versus Gradual Decannulation: a Randomised Control Trial
The investigators propose to examine the feasibility and safety of immediate (single stage) decannulation in adult patients in a controlled randomized trial. Patients who will be found fit for decannulation after an otolaryngologist and intensive care specialist assessment will be randomized into two groups: immediate decannulation and gradual decrease in cannula size. Both groups of patients will be monitored after decannulation and in the outpatient clinic for any complications following the procedure.
Recruitment of the patients will be demands for decannulation evaluation of different
departments in our institution. All patients who will agree to participate in the study and
meet the inclusion criteria would undergo three major steps"
1. Pre decannulation evaluation by otolaryngologist and intensive care specialist
following inclusion criteria.
2. Decannulation:
In the immediate decannulation group - the tracheostomy tube is removed and the patient
would be monitored overnight in an intermediate monitored unit. On the next day a
clinical evaluation would be held, and the patient would be discharge or transferred to
his department according to the clinical course of the patient.
In the gradual decannulation group:
The tracheostomy tube will be reduced in 2 sizes compared with the initial inner
diameter of the tube. The patients will remain with the reduced tube for 48 hours, and
the tube will be removed if the patients would meet pre-decannulation evaluation.
3. Follow up:
All patients would be followed in 7, 30, 90 days following decannulation in the outpatient
clinic or in their departments if still hospitalized. In these visit questionnaires
regarding possible respiratory complications will be documented.
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