Timing of tracheostomy in ICU patients with mechanical ventilation support
Xiubao Zhao, Yongqiang Wang, Huiyun Zhang, Fangchao Yao
Abstract
Xiubao Zhao, Yongqiang Wang, Huiyun Zhang, Fangchao Yao
Abstract
Objective To assess the influence of timing of tracheostomy performed on ICU patients with mechanical ventilation support for long-term. Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation. The differences in lengths of mechanical ventilation support (MVS), ICU stay, and hospital stay, incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics. Results Compared with group B, there were statistically significant reduction in duration of mechanical ventilation ( 7d vs.17 d; P 0.05). There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2= 0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2= 0.662) was found. Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU. These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy. Key words: Tracheotomy; Critical; Mechanical ventilation; ventilator-associated pneumonia
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Objective To assess the influence of timing of tracheostomy performed on ICU patients with mechanical ventilation support for long-term. Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation. The differences in lengths of mechanical ventilation support (MVS), ICU stay, and hospital stay, incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics. Results Compared with group B, there were statistically significant reduction in duration of mechanical ventilation ( 7d vs.17 d; P 0.05). There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2= 0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2= 0.662) was found. Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU. These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy. Key words: Tracheotomy; Critical; Mechanical ventilation; ventilator-associated pneumonia
Key concepts: Medicine, Mechanical ventilation, Tracheotomy, Intubation, Ventilator-associated pneumonia, Pneumonia, Ventilation (architecture), Anesthesia