The Effect of Tracheostomy Timing in Critically Ill Patients Undergoing Mechanical Ventilation

Document Type : Original papers

Authors

1 Assistant Lecturer of Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

2 Professor of Anesthesiology and Surgical Intensive Care Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

3 Professor of Otorhinolaryngology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

4 Assistant Professor of Anesthesiology and Surgical Intensive Care Department, Faculty of Medicine, Tanta University, Tanta, Egypt

5 Lecturer of Emergency Medicine and Traumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Abstract

Background: The ideal timing of tracheostomy in intensive care units (ICUs) for critically ill patients undergoing mechanical ventilation (MV) is still a matter of debate. The aim of this work was to determine and analyze the proper timing of tracheostomy and its impact on various clinical outcomes of adult patients in ICUs undergoing MV. Material and Methods: This prospective cohort observational study was carried out on 43 critically ill patients on MV in ICU patients aged ≥18 years old, both sexes, expected to be on prolonged MV. Patients were divided into two groups: Early tracheostomy (ET) group (n=20), who submitted to tracheostomy within 10 days post intubation. and late tracheostomy (LT) group (n=23), who submitted to tracheostomy between 11- and 21 days post intubation.
The correlation between the timing of tracheostomy of each group and various associated ICU clinical parameters were analyzed. Results: There was a positive correlation between ventilator-associated pneumonia (VAP) and mortality (P =0.013) which was statistically significant. There was a negative correlation between mortality and length of ICU stay (P=0.009), and duration of sedation (P=0.028) in ET Conclusions: ET had a notable benefit in VAP incidence, shortening the duration of the MV, lessening the sedation time, minimizing the risks of weaning failure and decreasing length of overall ICU stay, but it had no significant impact on mortality.

Keywords

References

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