UTILITY OF THE HIGH FLOW WITH NASAL CANNULA IN THE DECANULATION OF TRAQUEOTOMIZED PATIENTS DURING AN EPISODE OF ACUTE RESPIRATORY INSUFFICIENCY

HFNC may be an alternative to be used during the decannulation process in tracheotomized patients due to acute respiratory failure. Material and methods: Prospective, observational, descriptive study of a consecutive cohort. Population: Patients admitted to the pulmonology facility from the medical and surgical ICU of our hospital and who met the inclusion criteria established for this study: 1) admission to the ICU with a diagnosis of ARF or chronic exacerbated; 2) have been tracheotomized because they require prolonged orotracheal mechanical ventilation and cannot be weaned from artificial ventilation; 3) maintain a situation of clinical stability, that would allow their transfer to the ventilation unit; 4) receive mechanical ventilation by supportive tracheostomy at the time of reaching the ward. Patients with neuromuscular diseases were excluded. Decanulation protocol: transfer to fenestrated cannula with deflated balloon starting HFNC at 60 L/min and sufficient FIO2 to maintain sat> 92%. Decanulation after 48 hours with cannula in situ, occluded, without evidence of problems. The results are compared with our historical decannulation series with NIV. Results: We proceeded to the decannulation of 28 patients (5 COPD, 6 OHS, 17 postsurgical). The results are presented in Table 1, where they are compared with the results of 110 decanulated patients using NIV. The stay in ICU showed no differences, but there were differences in the stay of patients in the pulmonology ward and in the total stay in the hospital. Conclusions: HFNC is effective in patients tracheotomized by ARF without ventilatory dependence.