Maziak D E, Meade M O, Todd T R
Division of Thoracic Surgery, University of Toronto, Ontario, Canada.
Chest. 1998 Aug;114(2):605-9. doi: 10.1378/chest.114.2.605.
To examine the impact of the timing of tracheotomy on the duration of mechanical ventilation, the secondary changes to the trachea, and the clinical course of critically ill patients in the ICU.
A systematic review of the literature.
Two independent reviewers conducted a MEDLINE search for relevant literature in the form of randomized or observational controlled clinical studies. Studies were selected for review by criteria determined a priori; and the methodologic quality of selected studies was evaluated by duplicate independent review, also using criteria determined a priori.
Five studies were identified, of which three were quasirandomized and none were blinded. Agreement between reviewers of methodologic quality was high (kappa=0.87).
There is insufficient evidence to support that the timing of tracheotomy alters the duration of mechanical ventilation or extent of airway injury in critically ill patients.
探讨气管切开时机对重症监护病房（ICU）危重症患者机械通气时间、气管继发性改变及临床病程的影响。
文献系统综述。
两名独立审阅者以随机或观察性对照临床研究形式对MEDLINE进行相关文献检索。根据预先确定的标准选择研究进行综述；所选研究的方法学质量也通过重复独立审阅进行评估，同样使用预先确定的标准。
共识别出5项研究，其中3项为半随机研究，均未设盲。审阅者之间在方法学质量方面的一致性较高（kappa=0.87）。
尚无充分证据支持气管切开时机可改变危重症患者的机械通气时间或气道损伤程度。
