Use of hemi-cannula in patients with high risk of recannulation in an intermediate respiratory care unit. A descriptive analysis and study of the predictor variables of the use of posterior non-invasive mechanical ventilation

Abstract

Background

Information about the decannulation process in patients with high risk of recannulation is limited. However, devices such as the hemi-cannula, which maintain airway permeability for a controlled period, may enhance the safety of this process.

Aims

Describe and analyze the variables in the decannulation process of patients with high risk of recannulation, who have used a hemi-cannula and correlate these variables with the posterior need for Non-Invasive Mechanical Ventilation (NIMV).

Methods

Unicentric study analyzing a retrospective cohort of consecutive patients admitted to the Intermediate Respiratory Care Unit (IRCU) to continue the decannulation process from April 2022 to April 2024. Sociodemographic and clinical variables were described and analyzed. SPSS software was used to analyze the data with T student for independent data and Chi-square with Fischer correction.

Results

The final cohort included 19 patients, whom most of them had no previous respiratory pathology, but a 47.4 % had some cardiovascular risk factors. All of the patients had polyneuropathy at the admission to the IRCU. No 30-day mortality was observed in any patient. The recannulation rate was 10.5 %. 21 % of the patients required subsequent NIMV. Statistical significance at the analysis of the correlation between the mean number of days of Invasive Mechanical Ventilation (IMV) and the need for subsequent NIMV was found. However, there was not with the remaining variables.

Conclusions

The use of devices such as the hemi-cannula can enhance safety during the complex decannulation process in patients with high risk of recannulation, reducing the likelihood of reintubation or readmission to the Intensive Care Unit (ICU).