Objective:To investigate the feasibility of the getting off-line method by noninvasive mechanical ventilation whilekeeping the tracheotomy catheter for patients who had difficulty with conventional Sequential Invasive-Noninvasive off-line means.Methods:Data fron 15 patients with difficulty in off-line in ICU between January

2006 and December

2007 were analyzed.Once they had problems in clearing respiratory tract secretion spontaneously

aspiration of sputum through tracheotomy catheter would be applied to keep the airway unobstructed.Results:The invasive ventilation time of the 15 patients were(36.87 ±21.82)days.The average time of noninvasive mechanical ventilation were 11.5days

the shortest 5 days and the longest 38 days

respectively.All patients successfully got off-line.The rate of success was higher than that during the same period of 2004～2005 in comparison

when this method was not carried out.Conclusions:It is effective to apply the noninvasive mechanical ventilation while keeping the tracheotomy catheter to the patients who have difficulty in getting off-line due to unconsciousness

difficulty in clearing respiratory tract secretion spontaneously and repeated pulmonary infection

with enhanced success rate of sequential invasive-noninvasive off-line and emphasize to nurse mechanical ventilation.