Patients admitted to intensive care units (ICUs) frequently require prolonged mechanical ventilation. Difficulties in weaning from mechanical ventilation represent an important indication for performing a tracheotomy, which involves creating a temporary opening in the trachea into which a cannula is inserted. This procedure is often confused with a tracheostomy, in which a permanent stoma is created.
Tracheotomy offers several clinical benefits, including increased patient comfort, reduced sedation requirements, decreased work of breathing, improved oral hygiene, a lower risk of ventilator-associated pneumonia, and lower mortality. With the increasing use of the percutaneous technique, the procedure is increasingly performed by intensivists. Consequently, the number of patients with a tracheostomy cannula in the ICU is increasing.
Following clinical stabilisation, these patients are transferred to inpatient wards throughout the hospital according to their underlying pathology. However, nurses working on these wards encounter tracheostomy-related care less frequently, which may include suctioning, wound care, cannula care, and decannulation.
Despite the availability of clinical procedures and protocols, a lack of knowledge, skills, and confidence in providing safe tracheostomy-related care persists. This increases the risk of complications such as cannula obstruction, infection, hypoxaemia, dislodgement, and bleeding. To address this issue, specialised multidisciplinary tracheostomy teams are increasingly being implemented.
The aim of this retrospective study is to answer the following research question: What is the impact of a specialised multidisciplinary tracheostomy team on clinical outcomes in hospitalised patients with a tracheostomy cannula?
Hospitalisation between 2010 and 2026 in VITAZ (general hospital, Belgium)
Age ≥18 years.
Presence of a tracheostomy cannula (tracheotomy, permanent tracheostomy, or laryngectomy).
Curative and palliative patients will be included.
Ambulatory care
Day hospitalisation
This retrospective study will include adult patients aged ≥18 years who were hospitalised between 2010 and 2026 and had a tracheostomy cannula during their hospitalisation. The study population will include patients with a tracheotomy, permanent tracheostomy, or laryngectomy, irrespective of whether care was provided with curative or palliative intent. Both patients admitted to the intensive care unit and those subsequently transferred to inpatient wards will be included. Patients receiving ambulatory care or day hospitalisation will be excluded.
Other
Retrospective
The implementation of the specialised multidisciplinary tracheostomy team.
Other interventionThe intervention of interest is the implementation of the specialised multidisciplinary tracheostomy team, which provides structured, team-based care for patients with a tracheostomy cannula.
Tracheo(s)tomy-related ICU readmission
Occurrence of readmission to the intensive care unit due to tracheo(s)tomy cannula-related problems.
Successful decannulation
Successful decannulation of the tracheo(s)tomy cannula according to predefined criteria derived from the literature. The proportion of patients achieving successful decannulation will be compared between the pre-intervention and post-intervention cohorts.
Tracheo(s)tomy-related complications
Occurrence of predefined canulla-related complications, including airway obstruction, wound infection, bleeding, ... .
Performance of FEES
Performance of a fibreoptic endoscopic evaluation of swallowing (FEES) during hospitalisation.
Total hospital length of stay
From hospital admission until hospital discharge
Use of high-flow oxygen therapy or active humidification
Use of high-flow oxygen therapy and/or active humidification during hospitalisation.
Time to tracheo(s)tomy
Number of days from hospital admission to the performance of the tracheo(s)tomy.
Time from ICU admission to transfer to an inpatient ward
Duration of intensive care unit stay before transfer to an inpatient ward.
This trial is not recruiting at the moment. You can still explore other options:
