Introduction

Neuromuscular disorder (NMD) patients who have successfully removed tracheostomy tubes with the help of the non-invasive ventilation (NIV) and assistive coughing techniques have been reported.

Aims and objectives

The purpose of this study was to identify the transitions of the long-term respiratory management status of these patients.

Methods

Thirty-five NMD patients were successfully decannulated between 2007 and 2021. The medical records, discharge summaries, and thorough pulmonary function test results, including ventilation monitoring results, of each patient were retrospectively reviewed.

Results

Muscular dystrophy accounted for the majority of 14, and amyotrophic lateral sclerosis (ALS) was the second, 6. Hypercapnic respiratory arrest (48.57%) and uncontrolled pneumonia (40.00%) caused ARF in the most cases. Figure 1 showed transitions of respiratory management state of patients during follow up period. Finally, all patients were successfully decannulated with the support of NIV with manually assisted coughing or MI-E. The median (IQR) follow-up duration after decannulation was 2860.00 (2635.00) days and 6 patients who underwent re-tracheostomy were able to maintain NIV for 1619.00 (1771.00) days.

Conclusion

Non-invasive respiratory interventions are successful long-term alternatives for invasive mechanical ventilations and removing the unnecessary tracheostomy tube should be actively considered.