In patients with anoxic brain injury who have a tracheostomy, but “liberated” from the ventilator, and appear to be able to protect their airway, but have no meaningful neurological function, is there a role for decannulation?

Unfortunately, in patients with such severe brain injury that they have no meaningful neurologic function, decannulation would come at significant risk. Often, patients in these situations do not manage their secretion well and are at high risk for aspiration. With the trach in place, suctioning and...