THE USE OF PORTABLE VENTILATORS ADAPTED TO TRACHEOSTOMY IN CLINICAL PRACTICE
DOI:
https://doi.org/10.25110/arqsaude.v30i2.2026-12138Palavras-chave:
Tracheostomy, Ventilator weaning, Noninvasive ventilation.Resumo
Introduction: Introduction: The use of portable ventilators (PV) adapted to tracheostomy has been observed in critical patients in clinical practice. Objective: The study aimed to identify the characteristics associated with the indication for PV, patient outcomes, and survival. Methods: This was a prospective cohort study conducted with adult tracheostomized patients. Data collected included demographics, severity scores, reasons for ICU admission and intubation, days of mechanical ventilation (MV) until tracheostomy, cause of tracheostomy, and outcomes (ICU and hospital). Univariate analysis compared the groups with and without PV. Odds ratios (OR) assessed the likelihood of PV use, and age-adjusted logistic regression evaluated associated variables. Hospital survival was studied using the Kaplan-Meier method. Results: A total of 95 patients were included. The mean age was 71 years, with 58% being female. The median SAPS II was 55, and the Charlson Comorbidity Index was 4. Patients with an indication for PV (n=71) were older and had a longer continuous sedation time. Those intubated due to acute respiratory failure had a lower chance of using PV than those intubated for other causes. Hospital survival was higher in the PV group; however, the hospital mortality rate did not differ between the groups. Conclusion: PV use in tracheostomized patients was greater in the elderly and those intubated due to neurological causes or COPD. Despite higher survival, the similar hospital mortality rate suggests the need for further interventions. The literature reinforces that a multidisciplinary approach is essential to manage the complex dysfunctions in these patients with prolonged hospitalization.
Downloads
Referências
ABRIL, M. K. et al. The Epidemiology of Adult Tracheostomy in the United States 2002-2017: A Serial Cross-Sectional Study. Critical Care Explorations, [S. l.], v. 3, n. 9, e0523, 2021. DOI: https://doi.org/10.1097/CCE.0000000000000523
ARABI, Y. M. et al. The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients. Journal of Critical Care, [S. l.], v. 24, n. 3, p. 435–440, 2009. DOI: https://doi.org/10.1016/j.jcrc.2008.07.001
CANTARINI, K. V. et al. Telemonitoring in Home Mechanical Ventilation. Jornal Brasileiro de Pneumologia, Brasília, DF, v. 48, n. 6, e20220142, 2022. DOI: https://doi.org/10.36416/1806-3756/e20220142
FRADKIN, M. et al. A historical cohort study on predictors for successful weaning from prolonged mechanical ventilation and up to 3-year survival follow-up in a rehabilitation center. Respiratory Medicine, [S. l.], v. 227, 107636, 2024. DOI: https://doi.org/10.1016/j.rmed.2024.107636
FRUTOS-VIVAR, F. et al. Outcome of mechanically ventilated patients who require a tracheostomy. Critical Care Medicine, [S. l.], v. 33, n. 2, p. 290–298, 2005. DOI: https://doi.org/10.1097/01.CCM.0000150026.85210.13
GUIA, M. et al. The role of non-invasive ventilation in weaning and decannulating critically ill patients with tracheostomy: A narrative review of the literature. Pulmonology, Barcelona, v. 27, n. 1, p. 43-51, 2021. DOI: https://doi.org/10.1016/j.pulmoe.2020.07.002
HANSEN-FLASCHEN, J.; ACKRIVO, J. Practical Guide to Management of Long-Term Noninvasive Ventilation for Adults With Chronic Neuromuscular Disease. Respiratory Care, Irving, TX, v. 68, n. 8, p. 1123-1157, 2023. DOI: https://doi.org/10.4187/respcare.10349
IBRAHIM, S. G. et al. Use of a non-invasive ventilation device following tracheotomy: an alternative to facilitate ICU discharge? Revista Brasileira de Terapia Intensiva, São Paulo, v. 24, n. 2, p. 167-172, jun. 2012.
LIU, Y.; LI, T.; SHI, L. Long-term home mechanical ventilation using a noninvasive ventilator via tracheotomy in patients with myasthenia gravis: a case report and literature review. Therapeutic Advances in Respiratory Disease, [S. l.], v. 17, 17534666231165914, 2023. DOI: https://doi.org/10.1177/17534666231165914
NINAN, A. et al. Effectiveness of interprofessional tracheostomy teams: A systematic review. Journal of Clinical Nursing, [S. l.], v. 32, n. 19-20, p. 6967-6986, 2023. DOI: https://doi.org/10.1111/jocn.16815
ROSE, L.; MESSER, B. Prolonged Mechanical Ventilation, Weaning, and the Role of Tracheostomy. Critical Care Clinics, [S. l.], v. 40, n. 2, p. 409-427, 2024. DOI: https://doi.org/10.1016/j.ccc.2024.01.008
SHAH, N. M.; HART, N.; KALTSAKAS, G. Prolonged weaning from mechanical ventilation: who, what, when and how? Breathe, Sheffield, v. 20, n. 3, 240122, 2024. DOI: https://doi.org/10.1183/20734735.0122-2024
TEKIN, P.; BULUT, A. Tracheostomy Timing in Unselected Critically Ill Patients with Prolonged Intubation: A Prospective Cohort Study. Journal of Clinical Medicine, Basel, v. 13, n. 10, 2729, 2024. DOI: https://doi.org/10.3390/jcm13102729
VARGAS, M. et al. Follow-up short and long-term mortalities of tracheostomized critically ill patients in an Italian multi-center observational study. Scientific Reports, [S. l.], v. 14, n. 1, 2319, 2024. DOI: https://doi.org/10.1038/s41598-024-52785-y
YÁNEZ, S. R. P. O uso de ventilador portátil em pacientes com traqueostomia: desfechos clínicos. 2020. Dissertação (Mestrado em Ensino em Ciências da Saúde) – Campus Baixada Santista, Universidade Federal de São Paulo, Santos, 2020. Disponível em: https://repositorio.unifesp.br/items/e3e5d2c6-48a4-4232-9bd3-66eb9ad2c830. Acesso em: 13 nov. 2025.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Arquivos de Ciências da Saúde da UNIPAR
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os Direitos Autorais para artigos publicados são de direito da revista. Em virtude da aparecerem nesta revista de acesso público, os artigos são de uso gratuito, com Creative Commons Attribution 4.0 International License.
A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua e a credibilidade do veículo. Respeitará, no entanto, o estilo de escrever dos autores.
Alterações, correções ou sugestões de ordem conceitual serão encaminhadas aos autores, quando necessário. Nesses casos, os artigos, depois de adequados, deverão ser submetidos a nova apreciação.
As opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
