Resumo: Introduction: Placing a tracheostomy is a procedure commonly performed in intensive care units (ICU), with well-established protocols, so after tracheostomy, it is necessary to discuss and build work instructions that establish safe standards for safe weaning of the patient. tracheostomy (TQT). Objective: Investigate factors and or predictive events of failure in decannulation, using an institutional flowchart. Method: It was an analytical, retrospective, quantitative, and descriptive study, which occurred through the analysis of data available in the operating system of the Metropolitan Hospital of Urgency and Emergency, in which 128 patients admitted from January to December were analyzed 2019 who underwent tracheostomy, all over 18 years of age, in which 36 participants were included within the research criteria, who were considered to have decannulation failure. Results: 36 adults showed failure at some stage of the decannulation process, 12 of which were female and 24 were male, with an average age of 39.9 years. The most common diagnoses were traumatic brain injury (TBI) 29, followed by face trauma 7, spinal trauma (TRM) 5, firearm injury (FAF) 3, stab wound (FAB) 2 and finally 1 patient with burn trauma. Conclusion: The research demonstrated that dysphagia was the most pertinent factor of failure in decannulation among the predictors investigated. Also opening up a discussion about the need to update the decannulation flowchart used in the referred research hospital. Keywords: Decannulation, Dysphagia, Deglutition, Public health, Tracheostomy. Expandir Resumo Acessar Texto Completo

Resumo: Background: Tracheostomy can be performed as a preventive, curative, palliative or elective action, ist indication often happens due to failure in extubation, despite its benefits when it comes to respiratory comfort, there are also long-term harms, regarding changes that directly reflect on the swallowing and speech functions. Objective: This research aimed to analyze the process of difficult weaning and late decannulation in tracheostomized patients victims of trauma, looking for ways and analyzing what makes weaning difficult and late and how to improve this process. Methods: A descriptive-analogical, retrospective and quantitative study was conducted, with analysis of 40 medical records, from the first semester of 2018, with patients over 18 years of age classified as difficult weaning and late decannulation. For data collection, an instrument was used containing information about the functional diagnosis and related to weaning and decannulation. Results: Most of the patients undergoing tracheostomy classified as late weaning are men, victims of motorcycle accidents or physical aggressions that evolved with traumatic brain injury, and had an average of 10 to 11 days of orotracheal intubation, which was of great impact for the period prolonged tracheostomy. Conclusions: It was concluded that the patients who had had a speech therapy follow-up since the period of invasive mechanical ventilation with IOT about to extubate had shorter weaning time from the tracheostomy, compared with the patients who were only followed up after the tracheostomy. Keywords: weaning, speech therapy, tracheostomy. Expandir Resumo Acessar Texto Completo