Pulmonary Function Tests as Predictors of Successful Tracheostomy Decannulation: A 60-Day Prospective Study.

BACKGROUND

Early tracheostomy decannulation prevents complications, but premature removal poses risks. While various methods exist to assess readiness, the predictive role of pulmonary function tests remains unclear.

METHODS

This exploratory prospective observational study enrolled 46 patients at Chang Gung Memorial Hospital, Taoyuan, from March 2020 to December 2023. Participants underwent pulmonary function and coughing ability assessments-including forced vital capacity (FVC), peak expiratory flow rate (PEFR), maximum expiratory pressure (MEP), and oxygen saturation (SpO2)-prior to decannulation. Success was defined as no reinsertion within 60 days. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed.

RESULTS

Factors associated with a successful outcome were younger age, male sex, strong cough function, no nasogastric tube, and higher albumin levels. Key respiratory-function metrics (higher MEP, PEFR, FVC, and SpO2) were significantly linked to successful decannulation. FVC (≥ 1.35 L) and PEFR (≥ 95 L/min) strongly predicted success, with a combined metric (FVC + PEFR + MEP) achieving the highest accuracy.

CONCLUSION

For patients with an average tracheostomy duration of > 300 days, FVC, PEFR and MEP are feasible predictors of successful decannulation. Further studies are needed to validate these results.