Tekin Pınar, Bulut Azime
Department of Anesthesiology and Reanimation, Faculty of Medicine, Giresun University, 28100 Giresun, Türkiye.
J Clin Med. 2024 May 7;13(10):2729. doi: 10.3390/jcm13102729.
: Tracheostomy procedures are performed in the intensive care unit (ICU) for prolonged intubation, unsuccessful weaning and infection prevention through either percutaneous or surgical techniques. This study aimed to outline the impact of tracheostomy timing in the ICU on mortality, need for mechanical ventilation, and complications. : Patients were included in the study on the day of tracheostomy. Demographic information, tracheostomy timing, technique, complications, sedation requirement and need for mechanical ventilation at discharge were recorded by an anesthesiologist, including the pre-tracheostomy period. : Tracheostomy was performed on 33 patients during the first 14 days of intubation and on 54 patients on the 15th day and beyond. There was no significant difference between the tracheostomy timing and mortality, sedation requirement, or weaning from the ventilator. We observed that patients who underwent tracheostomy with the surgical technique experienced more complications, but there was no significant difference. Tracheostomy performed after the 14th day was shown to be associated with prolonged hospital stay. : Early tracheostomy does not have any influence on the need for mechanical ventilation, sedation and mortality. The optimal timing for tracheostomy is still controversial. We are of the opinion that randomized controlled trials involving patient groups with similar survival expectations are needed.
气管切开术在重症监护病房(ICU)中用于长期插管、撤机失败以及通过经皮或外科技术预防感染。本研究旨在概述ICU中气管切开时机对死亡率、机械通气需求和并发症的影响。
患者在气管切开当天纳入研究。麻醉医生记录人口统计学信息、气管切开时机、技术、并发症、镇静需求以及出院时的机械通气需求,包括气管切开术前阶段。
33例患者在插管的前14天内进行了气管切开术,54例患者在第15天及以后进行了气管切开术。气管切开时机与死亡率、镇静需求或脱机之间没有显著差异。我们观察到接受外科技术气管切开术的患者出现更多并发症,但差异无统计学意义。第14天后进行气管切开术与住院时间延长有关。
早期气管切开术对机械通气需求、镇静和死亡率没有任何影响。气管切开的最佳时机仍存在争议。我们认为需要针对具有相似生存预期的患者群体进行随机对照试验。