Decannulation outcomes in pediatric patients with acquired brain injury: a retrospective study.

Background: Decanulation in paediatric patients with tracheostomy due to acquired brain injury is a key objective in rehabilitation, and there is a lack of consensus about the optimal protocol and success factors in decannulation. Therefore, the aim of this study is to describe the experience of decannulation in a paediatric neurorehabilitation centre in Buenos Aires.

Methods: An observational, retrospective, and descriptive study was conducted on patients under 18 years old with acquired brain injury and tracheostomy, admitted between January 2016 and August 2023. Demographic, clinical data, and fibroendoscopy results were collected. Decannulation was performed according to institutional criteria, and a 48-hour monitoring period was implemented to evaluate post-decannulation complications.

Results: Of the 41 patients included in the study, 12 (29.3%) were successfully decannulated, while 29 (70.7%) were discharged with a speaking valve, an occluded cannula, or with the initial tracheostomy configuration. Fibroendoscopy was performed on 13 patients, detecting lesions in 11 cases.

Conclusions: The decannulation rate observed falls within the range documented in the literature, although it is closer to the lower end, which may be due to the complexity of the cases and the conservative approach adopted. The presence of disorders of consciousness and comorbidities were important factors in the decannulation process.