Pulmonary Function Tests as Predictors of Successful Tracheostomy Decannulation: A 60-Day Prospective Study

Background: Early tracheostomy decannulation prevents complications, but premature removal poses risks.While various methods exist to assess readiness, the predictive role of pulmonary function tests remains unclear.Methods: This exploratory prospective observational study enrolled 46 patients at Chang Gung Memorial Hospital, Taoyuan, from March 2020 to December 2023.Participants underwent pulmonary function and coughing ability assessments-including forced vital capacity (FVC), peak expiratory flow rate (PEFR), maximum expiratory pressure (MEP), and oxygen saturation (SpO2)-prior to decannulation.Success was defined as no reinsertion within 60 days.Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed.Results: Factors associated with a successful outcome were younger age, male sex, strong cough function, no nasogastric tube, and higher albumin levels.Key respiratory-function metrics (higher MEP, PEFR, FVC, and SpO2) were significantly linked to successful decannulation.FVC (≥ 1.35 L) and PEFR (≥ 95 L/min) strongly predicted success, with a combined metric (FVC + PEFR + MEP) achieving the highest accuracy. Conclusion:For patients with an average tracheostomy duration of > 300 days, FVC, PEFR and MEP are feasible predictors of successful decannulation.Further studies are needed to validate these results.