Early Tracheostomy Does Not Improve Outcome in Burn Patients

Saffle, Jeffrey R.; Morris, Stephen; Edelman, Linda S.

doi:10.1097/00004630-200211000-00009

Cited by 160 publications

(154 citation statements)

References 30 publications

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“…However, some of the studies failed to confirm this observation [18][19][20] . A few recent metaanalyses have also failed to confirm any favorable impact of early tracheotomy on mechanical ventilation duration and length of ICU stay 3,5 .…”

Section: Discussionmentioning

confidence: 99%

Early Versus Late Percutaneous Tracheotomy in Critically Ill Patients: A Retrospective Single Center Observational Study

Turković

Lukić

Perić

2016

ACC

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SUMMARY -Despite decades of experience in tracheotomy, there still exists a controversy over its ideal timing. The aim of our study was to compare the impact of early and late percutaneous tracheotomy in terms of their ability to reduce mechanical ventilation duration and length of stay in Intensive Care Unit, as well as the frequency of ventilator-associated pneumonia and mortality rates in tracheotomized patients. This retrospective observational study indicated that early tracheotomy in surgical and neurosurgical patients was associated with a reduced duration of mechanical ventilation and reduced length of stay in Intensive Care Unit, but was unable to reduce the frequency of ventilator-associated pneumonia and mortality. The reason behind the shorter duration of mechanical ventilation and shorter length of stay in Intensive Care Unit in the early tracheotomy arm was shorter duration of mechanical ventilation carried out prior to tracheotomy, while the duration of mechanical ventilation and the length of stay in Intensive Care Unit after tracheotomy were similar in both groups, suggesting that the procedure itself and not its timing influenced the duration of mechanical ventilation and the length of stay in Intensive Care Unit of tracheotomized patients.

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Section: Discussionmentioning

confidence: 99%

Early Versus Late Percutaneous Tracheotomy in Critically Ill Patients: A Retrospective Single Center Observational Study

Turković

Lukić

Perić

2016

ACC

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“…Early tracheostomy seems to decrease the duration of mechanical ventilation and length of ICU stay in certain critically ill populations, without effecting the morbidity and mortality [1,2,4,5,8,9,10]. Post tracheostomy care goes uninterrupted during the patient's stay in the ICU, but unfortunately there is no consensus regarding who is going to follow these patients after an ICU discharge.…”

Section: Discussionmentioning

confidence: 99%

Early Decannulation, Repatriation, and Hospital Discharges by Introducing a Tracheostomy Care Task Force for Noncritical Care Tracheostomized Patients

Ahmed¹,

Zaidi²,

Moshtohry³

et al. 2012

jot

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Objective. To determine the impact of an intensivist lead tracheostomy care team on the number of successful decannulations in non-critically ill patients and the time required for such decannulations and discharge from the hospital. Methods. Following the introduction of a multidisciplinary tracheostomy care task force, data was collected prospectively from July to December 2009. Matching control data was collected retrospectively from January to June 2009. Chi-Square and Mann-Whitney Utest were used to compare the differences in study variables with an α of 0.05. Results. A total of 44 and 47 patients with percutaneous tracheostomy (PCT) were discharged from the ICU pre-and post-implementation of the task force, respectively. Nine patients in pre-and 24 in postimplementation phase were decannulated, discharged from the hospital, and repatriated to their country of origin (Chi Sq. = 9.21, P = .002). Patients in pre-implementation group had longer hospital stay post ICU discharge compared to patients in post-implementation (58 vs. 34.1 days) group (P < .001). Conclusion. Structured multidisciplinary tracheostomy care team was associated with significant increase in number of decannulations, hospital discharges, and repatriation post ICU discharge.

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“…Mevcut çalışmalarda trakeostomi uygulanması ile VİP gelişimi arasındaki süre çok değişkendir, spesifik bir zaman belirtilmemiş-tir. Nseir ve ark.nın (14) Yakın zamanda trakeostomi ve VİP gelişimine ilişkin çalışmalar Tablo 1'de özetlenmiştir (38)(39)(40)(41)(42)(43)(44)(45). VİP tanımı için genellikle Center of Disease Control (CDC) ve CPIS skorunun kullanıldığı çalışmalarda erken trakeostomi açılan grup ile geç trakeostomi açılan grup arasında VİP insidansı açısından fark tespit edilmemiştir.…”

Section: Trakeostomi Zamanı Ve Ventilatör İlişkili Pnömoniunclassified

Relationship between Tracheostomy and Ventilator-associated Pneumonia in Intensive Care

Yıldırım¹,

Tahir²

2017

Yoğun Bakim Derg

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Tracheostomy is one of the most frequently performed surgical procedures in intensive care units (ICUs) for preventing complications caused by prolonged mechanical ventilation. Tracheostomy is advised to remove tracheobronchial secretions, facilitate weaning, and promote early oral feeding. Ventilator-associated pneumonia (VAP) is hospitalacquired pneumonia that develops 48 h after endotracheal intubation in patients without pneumonia at the beginning of intubation. VAP is a significant cause of mortality and morbidity, particularly in critically ill patients. In addition to its already known advantages, it is a debatable issue whether tracheostomy is a risk factor for VAP. The timing of the procedure is a topic that has been discussed in the literature. Previous studies have revealed that tracheostomy can be performed when the predicted intubation duration is 2 weeks or more. In this review, early or late tracheostomy and its effect on VAP development in ICUs will be discussed along with current literature. Trakeostomi yoğun bakım ünitelerinde (YBÜ) genellikle uzamış mekanik ventilasyonun (MV) yarattığı komplikasyonları önlemek için uygulanan bir cerrahi işlemdir. Trakeobronşiyal sekresyonların kolay uzaklaştırılması, MV'den ayrılmayı (weaning) kolaylaş-tırması ve erken oral beslenme sağlaması açısından tavsiye edilen bir uygulamadır. Ventilatör ilişkili pnömoni (VİP); entübasyon sırasında pnömonisi olmayan hastalarda endotrakeal entübasyondan 48 saat sonra gelişen hastane kökenli pnömonidir. VİP, kritik hastalarda önemli bir morbidite ve mortalite nedenidir. Trakeostominin bilinen avantajlarına ek olarak VİP açısından bir risk oluşturup oluşturmadığı ve zamanlaması halen literatürde tartışılan bir konudur.Yapılan çalışmalarla 2 haftadan daha uzun süre entübe kalacağı öngörülen hastalarda erken trakeostomi açılması önerilmektedir.Bu derlemede YBÜ'lerde izlenen hastalarda erken veya geç dönemde açılan trakeostominin VİP gelişimi açısından bir önemi olup olmadığı ortaya konulmaya çalışılmıştır. GirişVentilator ilişkili pnömoni (VİP) mekanik ventilasyon (MV) desteği alan kritik hastalarda YBÜ'de en sık karşılaşılan enfeksiyondur. Entübasyon sırasında pnömonisi olmayan, invaziv MV desteğindeki hastada entübas-yondan 48 saat sonra gelişen nozokomiyal pnömoni olarak tanımlanan VİP, entübe hastaların yaklaşık %8-%28'inde gelişir (1, 2). Genellikle medikal YBÜ hastalarında cerrahi YBÜ hastalarına göre daha sık görülür. Kritik hastalarda önemli bir morbidite ve mortalite nedenidir. Mortalite oranları %24 ile %50 arasında değişmekte ve bazı durumlarda %76'ya kadar çıka-bilmektedir (3). Etken mikroorganizmalar YBÜ'nün özelliklerine (medikalcerrahi), hasta popülasyonuna, YBÜ'de kalış süresine ve altta yatan hastalıklara göre değişkenlik gösterir. En sık tespit edilen mikroorganizmalar Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacteriaceae ve ülkemizde Acinetobacter baumanii'dir (4). VİP gelişimi için en önemli risk faktörü MV'de kalış süresidir. Re-entübasyon, akut hastalığın ağırlığı (Acute Physiology and Chro...

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Early Tracheostomy Does Not Improve Outcome in Burn Patients

Cited by 160 publications

References 30 publications

Early Versus Late Percutaneous Tracheotomy in Critically Ill Patients: A Retrospective Single Center Observational Study

Early Versus Late Percutaneous Tracheotomy in Critically Ill Patients: A Retrospective Single Center Observational Study

Early Decannulation, Repatriation, and Hospital Discharges by Introducing a Tracheostomy Care Task Force for Noncritical Care Tracheostomized Patients

Relationship between Tracheostomy and Ventilator-associated Pneumonia in Intensive Care

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