Effect of Early vs Late Tracheostomy Placement on Survival in Patients Receiving Mechanical Ventilation

Young, Duncan; Harrison, David A; Cuthbertson, Brian H.; Rowan, Kathy

doi:10.1097/01.sa.0000443870.68248.ea

Cited by 34 publications

(42 citation statements)

References 1 publication

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“…Previously, it was suggested that after one week of intubation, if extubation does not appear likely within a week, tracheostomy should be performed [14]. The TracMan trial [15] classified tracheostomy into early tracheostomy, within four days and late tracheostomy, after 10 days of intubation and found no difference in the primary outcome (30-day mortality) or other secondary outcomes. Tracheostomy allows for easier tracheobronchial toileting and early weaning of patients on mechanical ventilators.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Ventilation in the Intensive Care Unit: A Prospective Study of Indications and Factors that Affect Outcome in a Tertiary Hospital in Nigeria

Ku¹,

It²,

Ochukpe³

2017

J Anesth Clin Res

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The need for ventilatory support is one of the commonest indications for admission into the intensive care unit (ICU). Despite the usefulness of mechanical ventilation, its damaging effect on the lungs has also been widely recognized.The study was a prospective, case-controlled survey of all mechanically ventilated patients admitted in our ICU from November 2013 to April 2014. For every ventilated patient, a non-ventilated similar patient served as a control.A total of 128 patients were admitted into the ICU over the six month period and 44 patients constituting 34.4% were mechanically ventilated. The average duration of mechanical ventilation was 12.30 ± 10.10 days. Duration of mechanical ventilation, use of arterial blood gas measurement and ionotropic support had significant effect on weaning from ventilation with p values of 0.005, 0.05 and <0.001 respectively. Mechanically ventilated patients had >4 times chance of death than non-ventilated patients.Mechanical ventilation though a useful therapeutic intervention in the ICU is associated with increased mortality. Duration of ventilation, use of arterial blood gas (ABG) and need for ionotropic support influenced successful weaning off ventilator. It may be expedient therefore to weigh the risk: benefit assessment of mechanical ventilation before commencement in the ICU.

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Section: Discussionmentioning

confidence: 99%

Mechanical Ventilation in the Intensive Care Unit: A Prospective Study of Indications and Factors that Affect Outcome in a Tertiary Hospital in Nigeria

Ku¹,

It²,

Ochukpe³

2017

J Anesth Clin Res

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“…However, there is now evidence to suggest that early tracheostomy in this situation does not necessarily improve outcome. 1 Patients with head and neck conditions including cancer continue to have tracheostomies formed surgically and this is generally (as with percutaneous formation) a temporary measure to ensure airway patency until treatment is completed.…”

Section: Introductionmentioning

confidence: 99%

Are we ‘on the right trach?’ The National Confidential Enquiry into Patient Outcome and Death examines tracheostomy care

2015

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Objectives: The National Confidential Enquiry into Patient Outcome and Death presents a detailed survey of practice, encompassing the care pathway for patients with a new tracheostomy formed in hospital, alongside a review of organisational aspects of care.Results: Tracheostomy formation has come to be regarded as a relatively low-risk procedure that can be carried out safely at the bedside, even in high-risk patients. Information on how many procedures are carried out percutaneously has been poor and not captured by existing UK data collection systems.Conclusion: The study reinforces recommendations made by other healthcare groups, and presents new information which can be used as a basis for discussion and future planning to improve patient outcomes. The importance of meticulous ongoing care of a tracheostomy is recognised as important to prevent patient complications. Bedside staff must have the knowledge, competencies and confidence to deal with common and potentially life-threatening emergencies when they occur.

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“…More importantly, the prediction of prolonged need for ventilation is uncertain, as evidenced by the fact that only about 50% of the patients randomized for late tracheostomy ultimately underwent it. 10,13 The story of tracheostomy in the ICU will continue to run, looking for more conclusive results. Until new data arise, one may recommend either early tracheostomy or prolonged translaryngeal intubation.…”

mentioning

confidence: 99%

Early Tracheostomy or Prolonged Translaryngeal Intubation in the ICU: A Long Running Story

Banfi

Robert

2013

Respir Care

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Effect of Early vs Late Tracheostomy Placement on Survival in Patients Receiving Mechanical Ventilation

Cited by 34 publications

References 1 publication

Mechanical Ventilation in the Intensive Care Unit: A Prospective Study of Indications and Factors that Affect Outcome in a Tertiary Hospital in Nigeria

Mechanical Ventilation in the Intensive Care Unit: A Prospective Study of Indications and Factors that Affect Outcome in a Tertiary Hospital in Nigeria

Are we ‘on the right trach?’ The National Confidential Enquiry into Patient Outcome and Death examines tracheostomy care

Early Tracheostomy or Prolonged Translaryngeal Intubation in the ICU: A Long Running Story

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