A Comparison between Early and Late Tracheostomy in Critically Ill Patients
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- Category: Vol. 81, June 2013
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A Comparison between Early and Late Tracheostomy in Critically Ill Patients,JACK E. KHALIL, MAGED ABU ELMAGD, HAMDY M. SABER, ASHRAF RAGAB and FAHIM RAGAB
Abstract
Background and Objectives: Tracheostomy is one of the most common procedures performed in intensive care units. Timing of tracheostomy on an intubated critically ill patient has been very controversial. Recommendations range from performing a tracheostomy after just 3 days to more than 21 days after translaryngeal intubation due to the risk of mucosal damage to the larynx and vocal cords. This study aims to compare between critically ill patients outcome after either early tracheostomy (ET) (10 days) or late tracheostomy (LT) (10 days).
Study Design: This is a non-randomized single-center cohort study that was prospectively conducted on 60 critically ill mechanically ventilated patients, scheduled for tracheosto-mies between January 2010 to January 2011. Patients were divided into two groups; group A: 30 patients who underwent LT and group B: 30 patients underwent ET. All the demo-graphic, intra-operative and postoperative data were prospec-tively collected and analyzed statistically.
Results: There was no significant difference between both groups concerning the baseline demographic data, the ICU admission diagnosis, co-morbidities and intra-operative com-plications. However, but early post-operative complications were significantly higher in the LT group compared to the ET group. The duration of ICU stay, mechanical ventilation, and mortality were significantly higher in the LT compared to the ET group.
Conclusion: There was a higher incidence of early post-operative complications and mortality in the LT group com-pared to the ET group in critically ill patients in Egypt. Hence, we suggest ET for the management of mechanically ventilated critically ill patients who are indicated for prolonged mechan-ical ventilation.