通过气管切开插管撤机方案对长期机械通气的气管切开患者进行早期无创通气和渐进式高流量氧疗

实验性的：Standardized Weaning Protocol

Participants in this single-group study received a standardized stepwise weaning protocol in a specialized weaning unit. The protocol included daily assessment of clinical stability and weaning readiness, gradual reduction of ventilatory support, spontaneous breathing trials when clinically feasible, early noninvasive ventilation when appropriate, progressive high-flow oxygen therapy through the tracheostomy tube, airway clearance, rehabilitation, nutritional support, and multidisciplinary reassessment.

其他：Standardized Stepwise Weaning Protocol

The intervention was a standardized stepwise weaning protocol for tracheostomized patients requiring prolonged mechanical ventilation. Clinical stability and readiness for weaning were assessed before protocol initiation. Ventilator support was gradually reduced according to patient tolerance. When patients met predefined readiness criteria, spontaneous breathing trials were performed under pressure support ventilation. Patients who tolerated spontaneous breathing trials transitioned to progressively longer periods of high-flow oxygen therapy delivered through the tracheostomy tube. Noninvasive ventilation was used when appropriate to support transition from invasive ventilation and facilitate liberation from ventilatory support. Patients were reconnected to the ventilator if signs of respiratory distress or clinical instability occurred. Airway clearance, rehabilitation, nutritional support, and multidisciplinary reassessment were integrated throughout the protocol.

Percentage of Participants With Successful Weaning Within 60 Days

Successful weaning was defined as breathing without invasive mechanical ventilator assistance for at least 5 consecutive days. The outcome was calculated as the percentage of enrolled participants who achieved successful weaning within 60 days after enrollment.

Time From Enrollment to Successful Weaning

Weaning duration was defined as the number of days from enrollment to the first day on which the participant met the definition of successful weaning.

Percentage of Successfully Weaned Participants Reconnected to Invasive Ventilation Within 30 Days

Reconnection was defined as the need to resume invasive mechanical ventilator assistance within 30 days after successful weaning. This outcome was calculated among participants who achieved successful weaning.

All-Cause Mortality at 6 Months

All-cause mortality was defined as death from any cause within 6 months after enrollment.