Timing of Tracheostomy for Patients Requiring Mechanical Ventilation

Objective To assess the impact of tracheostomy timing on the outcome of patients requiring mechanical ventilation(MV).Methods From April 2006 to June 2009,121 patients under MV who received tracheostomy were divided into two groups: early tracheostomy group when tracheostomy was performed before or on day 7 and late tracheostomy group when it was performed thereafter.The writers compared the lengths of MV,length of stay in ICU,prevalence of ventilator associated pneumonia and mortality rates between the two groups.Results 121 patients underwent tracheostomy,54 of whom had early tracheostomy and 67 had late tracheostomy.Early tracheostomy was associated with significant reduction of length of MV(6.2±4.6 vs 8.4±4.4 days,P0.05),length of stay in ICU(12.1±5.1 vs 14.4±6.9 days,P0.05) and prevalence of ventilator associated pneumonia(20.4% for early tracheostomy group and 38.8% for late tracheostomy group,P0.05).There were no differences in mortality rates between the two groups(24.1 vs 29.9%, P0.05).Conclusion This study demons-trates that early tracheostomy(≤7 days) is associated with shorter duration of MV,shorter ICU length of stay and low VAP rate without affecting survival.