Aerodynamic measures of patients with tracheostomy capping before and after decannulation

Background: Gradually stepped decannulation, such as capping with fenestrated tubes or tube downsizing, is likely to prolong the decannulation process. The purpose of the study is to determine the differences in laryngeal aerodynamic measures, expiratory peak flow, and dyspnea index when breathing through the upper airway before and after decannulation. The study recruited sixteen adult patients with a tracheostomy who were fit for decannulation. Measurement of peak flow rate, aerodynamic measures, and dyspnea index has been done at two settings: first during capping and second after decannulation by 2 h using finger support to close the stoma and prevent air leak. Results: Changes in outcome measures after decannulation revealed a significant increase in peak flow rate, vital capacity, maximum phonation, and phonatory speech pressure level; the glottal resistance significantly decreased after decannulation. The dyspnea severity index scores improved from 22.35 during capping to 13.37 after decannulation. Conclusions: The results of our study showed that tracheostomy tube capping causes a significant reduction in peak flow and aerodynamic measures which improved after tracheostomy decannulation.