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[Impact of early elective tracheotomy in critically ill patients].

AbstractINTRODUCTION:
Tracheotomy is one of the most frequent surgical procedures performed in critically ill patients hospitalized at intensive care units. The ideal timing for a tracheotomy is still controversial, despite decades of experience.
OBJECTIVE:
To determine the impact of performing early tracheotomies in critically ill patients on duration of mechanical ventilation, intensive care unit stay, overall hospital stay, morbidity, and mortality.
METHODS:
Retrospective and observational study of cases subjected to elective tracheotomy at one of the intensive care units of this hospital during five consecutive years. The patients were stratified into two groups: early tracheotomy group (tracheotomy performed from day one up to and including day seven of mechanical ventilation) and late tracheotomy group (tracheotomy performed after day seven). The outcomes of the groups were compared.
RESULTS:
In the early tracheotomy group, there was a statistically significant reduction in duration of mechanical ventilation (6 days vs. 19 days; p<0.001), duration of intensive care unit stay (10 days vs. 28 days; p=0.001), and incidence of ventilator-associated pneumonia (1 case vs. 44 cases; p=0.001).
CONCLUSION:
Early tracheotomy has a significant positive impact on critically ill patients hospitalized at this intensive care unit. These results support the tendency to balance the risk-benefit analysis in favor of early tracheotomy.
AuthorsIsabel Araújo Marques Correia, Vítor Sousa, Luis Marques Pinto, Ezequiel Barros
JournalBrazilian journal of otorhinolaryngology (Braz J Otorhinolaryngol) 2014 Sep-Oct Vol. 80 Issue 5 Pg. 428-34 ISSN: 1808-8686 [Electronic] Brazil
Vernacular TitleImpacto da traqueotomia eletiva precoce nos doentes críticos.
PMID25303819 (Publication Type: English Abstract, Journal Article, Observational Study)
CopyrightCopyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
Topics
  • Aged
  • Critical Illness (mortality)
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors
  • Tracheotomy (adverse effects, methods)

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