Rehabilitative intervention for successful decannulation in adult patients with acquired brain injury and tracheostomy: a systematic review

Research output: Contribution to journalReviewResearchpeer-review

  • Signe Janum Eskildsen
  • Wessel, Irene
  • Ingrid Poulsen
  • Carrinna Aviaja Hansen
  • Derek John Curtis

Purpose: Tracheostomy and dysphagia are independently associated with increased complications and poorer functional outcome after acquired brain injury (ABI). The aim of this study was to identify and evaluate rehabilitation to restore functional swallowing ability and respiratory capacity during tracheal tube weaning. Materials and methods: The review was conducted according to PRISMA guidelines. Any study design with adult patients with ABI and tracheostomy was eligible. The primary outcome was decannulation. Results: A total of 2647 records were identified and eight papers included. Four studies investigated pharyngeal electrical stimulation (PES), two explored Facial Oral Tract Therapy (F.O.T.T.), one respiratory physiotherapy (RPT), and one study investigated external subglottic air flow (ESAF). Two RCTs found a significant difference between intervention and control on successful decannulation and readiness for decannulation in favour of PES. Time from rehabilitation admission and tracheostomy to decannulation was significantly reduced after implementing an F.O.T.T.-based protocol. Conclusion: Four interventions were identified, PES, F.O.T.T., RPT, and ESAF, all aimed at increasing oropharyngeal sensory input through stimulation. Due to heterogeneity of interventions, designs and outcome measures, effect could not be estimated. This review highlights the limited research on rehabilitative interventions and thus the limited evidence to guide clinical rehabilitation.

Original languageEnglish
JournalDisability and Rehabilitation
ISSN0963-8288
DOIs
Publication statusE-pub ahead of print - 2024

Bibliographical note

Publisher Copyright:
© 2023 Informa UK Limited, trading as Taylor & Francis Group.

    Research areas

  • brain injury, decannulation, Rehabilitation, systematic review, tracheostomy, weaning

ID: 365821932