McCormick Tim, Venn Richard
Worthing Hospital, Lyndhurst Road, Worthing BN11 2DH, UK.
Crit Care. 2007;11(2):127. doi: 10.1186/cc5725.
Three studies explore the case for tracheostomies in the intensive care unit (ICU). Tracheostomies appear to have no effect on ICU survival, according to a prospective observational cohort study that used a propensity score. In obese patients, surgical tracheostomies were associated with an increased risk of complications, although these patients appeared to have a lower mortality in the ICU. A third study failed to show that tracheostomies reduced sedation requirements. MRI appears to be the investigation of choice for the diagnosis of acute stroke and thrombolysis is a safe and effective treatment for acute ischaemic strokes. Virtually all patients with a stroke may benefit from ongoing care in a stroke unit.
三项研究探讨了重症监护病房（ICU）中行气管切开术的情况。一项使用倾向评分的前瞻性观察队列研究表明，气管切开术似乎对ICU患者的生存率没有影响。在肥胖患者中，外科气管切开术与并发症风险增加相关，不过这些患者在ICU中的死亡率似乎较低。第三项研究未能表明气管切开术可降低镇静需求。磁共振成像（MRI）似乎是诊断急性中风的首选检查方法，而溶栓治疗是急性缺血性中风的一种安全有效的治疗方法。几乎所有中风患者都可能从在中风单元接受持续护理中获益。
