Presión inspiratoria mantenida en pacientes pediátricos traqueostomizados como indicador de tolerancia al uso de cánula tapada

Resumen

Introduction: The prolonged use of tracheostomy leads to several complications, being necessary a prompt and safe decannulation. Maintained Inspiratory Airway Pressure (PiMant) is a functional evaluation of the dynamic changes of upper airway in inspiration which could indicate the tolerance to capped tracheostomy and adapting to this new airflow resistance, prior to decannulate. Methods: Sixteen tracheostomized patients were evaluated with PiMant using a vacuum gauge, recording pressure value, oxygen saturation, respiratory rate, heart rate, accesory muscles use and presence of stridor during 15 minutes. Results: Median age 60 months-old, pressure range -2 to -40 cmH2O. PiMant values > -7 cmH2O were associated with better tolerance to capped tracheostomy. Stridor was associated to increase of respiratory effort being the best criteria to bring to a halt the test. Conclusions: PiMant is a safe assessment, and indicates tolerance to capped tracheostomy when values > -7 cmH2O are found.