Clinical management and nursing care for patients with tracheostomy following traumatic brain injury

Tracheostomy is a routine surgical procedure in patients with severe traumatic brain injury, which requires mechanical ventilation to maintain gas exchange and avoid hypoxemia. Inadequate tracheostomy timing, nursing care, and decannulation would lead to a series of complications, such as aggravated pneumonia and prolonged intubation. The effects of early tracheostomy versus late tracheostomy have been explored. And early tracheostomy is more likely associated with shorter hospital stays and fewer complications. But the relevant reports are controversial. A safe and fast tracheostomy decannulation would facilitate the recovery. However, there was a broad variability in the indications and timing of tracheostomy and decannulation. High-quality evidence is subsequently lacking. We conducted this review to address gaps in knowledge regarding the management strategy and nursing protocol in patients with tracheostomy and decannulation following traumatic brain injury. A multidisciplinary tracheostomy team containing nursing care was also discussed to provide the best service to these patients.