Kluger Y, Paul D B, Lucke J, Cox P, Colella J J, Townsend R N, Raves J J, Diamond D L
Trauma Center, Tel Aviv Sourasky Medical Center, Israel.
Eur J Emerg Med. 1996 Jun;3(2):95-101. doi: 10.1097/00063110-199606000-00007.
A retrospective analysis of 118 trauma patients who underwent tracheostomy for airway and pulmonary management was undertaken. Timing of the procedure was defined as early (0-3 days), intermediate (4-7 days), and late (> 7 days). Head injury patients received tracheostomy early (p < 0.00003). Aspiration evaluated by modified bedside aspiration test was a frequent occurrence in all three groups with no difference in incidence (p < 0.34). Pneumonia was less frequent in the early group compared with the intermediate and late groups (p < 0.0034). The incidence of pneumonia in the early group was not different from that observed in early extubated patients (n = 282; p < 0.23). Our study suggests that early tracheostomy may decrease pulmonary septic complications in trauma patients. Although no change in length of stay can be attributed to the early performance of tracheostomy, preventing pneumonia in the intensive care unit setting with its resulting high expense is beneficial.
对118例因气道和肺部管理而接受气管切开术的创伤患者进行了回顾性分析。手术时机分为早期（0 - 3天）、中期（4 - 7天）和晚期（>7天）。头部受伤患者早期接受气管切开术（p < 0.00003）。通过改良床边吸引试验评估的误吸在所有三组中均频繁发生，发生率无差异（p < 0.34）。与中期和晚期组相比，早期组肺炎发生率较低（p < 0.0034）。早期组肺炎发生率与早期拔管患者（n = 282；p < 0.23）观察到的发生率无差异。我们的研究表明，早期气管切开术可能会减少创伤患者的肺部感染并发症。虽然住院时间的变化不能归因于早期进行气管切开术，但在重症监护病房环境中预防肺炎及其带来的高昂费用是有益的。
