TY - JOUR T1 - The role of non-invasive ventilation in weaning and decannulating critically ill patients with tracheostomy: A narrative review of the literature JO - Pulmonology T2 - AU - Guia,Miguel AU - Ciobanu,Laura D AU - Sreedharan,Jithin K AU - Abdelrahim,Mohamed E. AU - Gonçalves,Gil AU - Cabrita,Bruno AU - Alqahtani,Jaber S. AU - Duan,Jun AU - El-Khatib,Mohamad AU - Diaz-Abad,Montserrat AU - Wittenstein,Jakob AU - Karim,Habib M.R. AU - Bhakta,Pradipta AU - Ruggeri,Paolo AU - Garuti,Giancarlo AU - Burns,Karen E.A. AU - Soo Hoo,Guy W. AU - Scala,Raffaele AU - Esquinas,Antonio SN - 25310437 M3 - 10.1016/j.pulmoe.2020.07.002 DO - 10.1016/j.pulmoe.2020.07.002 UR - https://www.journalpulmonology.org/en-the-role-non-invasive-ventilation-in-articulo-S2531043720301513 AB - IntroductionInvasive mechanical ventilation (IMV) is associated with several complications. Placement of a long-term airway (tracheostomy) is also associated with short and long-term risks for patients. Nevertheless, tracheostomies are placed to help reduce the duration of IMV, facilitate weaning and eventually undergo successful decannulation. MethodsWe performed a narrative review by searching PubMed, Embase and Medline databases to identify relevant citations using the search terms (with synonyms and closely related words) “non-invasive ventilation”, “tracheostomy” and “weaning”. We identified 13 publications comprising retrospective or prospective studies in which non-invasive ventilation (NIV) was one of the strategies used during weaning from IMV and/or tracheostomy decannulation. ResultsIn some studies, patients with tracheostomies represented a subgroup of patients on IMV. Most of the studies involved patients with underlying cardiopulmonary comorbidities and conditions, and primarily involved specialized weaning centres. Not all studies provided data on decannulation, although those which did, report high success rates for weaning and decannulation when using NIV as an adjunct to weaning patient off ventilatory support. However, a significant percentage of patients still needed home NIV after discharge. ConclusionsThe review supports a potential role for NIV in weaning patients with a tracheostomy either off the ventilator and/or with its decannulation. Additional research is needed to develop weaning protocols and better characterize the role of NIV during weaning. ER -