Withdrawal of tracheostomy

There is significant variability in the indication for tracheostomies and in how dependent a patient may be on a tracheostomy for airway patency or ventilatory support. Often a tracheostomy remains in place for end-of-life care and does not complicate the dying process. Patients who choose to continue having a tracheostomy in the last days of life and have respiratory distress or agitation can be managed adequately with symptom management routinely used in the last days of life—see Agitation and restlessness in the last days of life.

If a decision is made to decannulate a tracheostomy in a patient, or withdraw ventilatory support, specialist input is required to ensure clinicians with skills in decannulation and sedation are available, and to prepare the patient, family and staff for the withdrawal process.