Table 2.
Recent publications, pediatric decannulation protocols
| Primary author, year | Patient population | N | Standardized decannulation protocol | Inpatient nights required (if specified) | Failure rate (first decannulation, if multiple) | Risk factors for failure |
|---|---|---|---|---|---|---|
| Cristea, 2016 [60•] | < 18 y/o | 210 | Admission MLB or sleep endoscopy; decannulation in sleep lab with immediate PSG; formal PSG | 1 | 20.4% | |
| Lee, 2016 [68•] | < 18 y/o | 30 | Downsize to 3-mm tube; awake capping; admission with overnight pulse oximetry; formal capped PSG; decannulation; discharge | 2 | 13.3% | |
| Beaton, 2016 [67•] | < 18 y/o | 45 | MLB; trach tube downsize; trach tube capping; decannulation; overnight observation; discharge | 4 | 44.5% | - |
| Banyopadhyay, 2016 [61•] | < 18 y/o | 189 | MLB with temporary decannulation; admission with decannulation and immediate PSG; overnight PSG; discharge | 1 | 22.2% | Prematurity, decannulation based on parental expectations of success, dysphagia, craniofacial/genetic comorbidities, hydrocephalus, BPD |
| Wirtz, 2016 [62•] | < 18 y/o | 35 | Sleep endoscopy ± MLB with temporary decannulation; PICU admission with decannulation; discharge | 1+ | 5.7% | - |
| Maslan, 2017 [63•] | < 18 y/o | 46 | No fixed protocol, most underwent MLB and PSG | Variable | 2.1% | - |
| Pozzi, 2017 [64•] | < 18 y/o in inpatient rehab | 68 | Inpatient capping trials with continuous pulse oximetry; fiberoptic laryngoscopy; selective PSG only | N/A (inpatient for rehab) | 0% | |
| Seligman, 2019 [65•] | 0–5 y/o | 26 | MLB; change to fenestrated trach tube when awake; inpatient overnight pulse oximetry; decannulation; half-day pulse oximetry; discharge | 1 | 15.3% | - |
| Morrow, 2019 [66•] | 0–21 y/o with brain or spinal cord injuries who underwent PSG for decannulation | 38 | Capped PSG during inpatient stay; selective airway endoscopy | N/A (inpatient for rehab) | 0% | - |
Summary of decannulation studies published since 2016. N, number of patients in the cited study; y/o, years old; MLB, microlaryngoscopy and bronchoscopy; PSG, polysomnogram; BPD, bronchopulmonary dysplasia; N/A, not applicable