The course of rehabilitation of ventilated and tracheally cannulated patients in neurological-neurosurgical early rehabilitation.

With optimized emergency, stroke, and intensive care management, a growing number of patients now survive major cerebral infarctions, intracranial hemorrhages, severe acute brain injuries, resuscitation, and critical care with subsequent neurological complications (1).Many require follow-up rehabilitation.Neurological rehabilitation in Germany follows the "Phase Model" developed by the Federal Association for Rehabilitation (BAR) (2): Phase A = primary treatment in a hospital for acute cases; Phase B = specialized early rehabilitation center for neurological-neurosurgical early rehabilitation (NNR); Phase C = follow-up rehabilitation (patients still need care but can already participate actively in [group] therapy).Not infrequently, patients transitioning to Phase B still have tracheostomy cannulas and, in some cases, require ongoing ventilation.Weaning from mechanical ventilation and decannulation are the main therapeutic goals of NNR, with the aim of establishing the requirements for Phase C. Weaning and decannulation are achieved in 65 to 82% and 52 to 54% of cases, respectively (3, 4).Patients who cannot be weaned from ventilation or decannulated receive care in out-of-hospital intensive care units (OOH-IC) or in Phase F (long-term) facilities.Against a background of increasing care demands, weaning from mechanical venti-