{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:17:35Z","timestamp":1783577855477,"version":"3.55.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Objective<\/jats:title>\n Optimized decannulation timing in tracheostomized patients with acquired brain injury (ABI) remains a significant clinical challenge. We examined the association between the 3-week change in forced vital capacity (FVC) and time to successful decannulation, including possible nonlinear threshold effects.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This prospective observational cohort study enrolled 56 tracheostomized patients with ABI. FVC was measured at baseline (T0) and at 3\u202fweeks (T1, \u0394FVC\u202f=\u202fFVC_T1\u202f\u2212\u202fFVC_T0) using ATS\/ERS-compliant spirometry. The primary outcome was time from T0 to successful decannulation (\u226572\u202fh without reintubation or reinsertion). Multivariable linear regression, generalized additive models, and threshold effect analysis were performed after adjustment for age, sex, disease duration, diagnosis, and hemiplegic side.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort (\n N<\/jats:italic>\n \u202f=\u202f56; mean age 51.0\u202f\u00b1\u202f7.6\u202fyears; 55.4% male) comprised cerebral infarction (44.6%), cerebral hemorrhage (33.9%), and traumatic brain injury (21.4%). In the adjusted linear model, each 1-L increase in \u0394FVC was associated with 8.7\u202fdays shorter time to decannulation (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22128.677\u202fdays\/L, 95% CI: \u221212.399 to \u22124.955,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). A threshold effect was identified at \u0394FVC\u202f=\u202f0.52\u202fL: below this threshold, the association was pronounced (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u221213.616\u202fdays\/L,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001); above it, the association was attenuated and non-significant (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22122.244\u202fdays\/L,\n p<\/jats:italic>\n \u202f=\u202f0.492).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Interval FVC monitoring may serve as a practical adjunct in decannulation assessment. A \u0394FVC of 0.52\u202fL or greater may serve as a clinically useful reference point for initiating comprehensive decannulation evaluation in patients with ABI undergoing pulmonary rehabilitation. This threshold should be interpreted cautiously and validated in larger multicenter studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1798877","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:34:15Z","timestamp":1783575255000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Decannulation criteria in patients with acquired brain injury based on interval forced vital capacity monitoring: a prospective observational study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yunhong","family":"Deng","sequence":"first","affiliation":[{"name":"Clinical College of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine","place":["Guangzhou, Guangdong, China"]},{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuqiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaojiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbo","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bizhou","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Hao","sequence":"additional","affiliation":[{"name":"Clinical College of Acupuncture and Rehabilitation, Guangzhou University of Chinese Medicine","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"E47","DOI":"10.1097\/htr.0000000000000108","article-title":"An overview of acquired brain injury rehabilitation randomized controlled trials","volume":"30","author":"McIntyre","year":"2015","journal-title":"J Head Trauma Rehabilitation"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.pmr.2021.01.001","article-title":"Telerehabilitation in acquired brain injury","volume":"32","author":"Subbarao","year":"2021","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1177\/17474930241308142","article-title":"World stroke organization: global stroke fact sheet 2025","volume":"20","author":"Feigin","year":"2025","journal-title":"Int J 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