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Am J Surg. 2005 Mar;189(3):293-6.

Early tracheostomy versus late tracheostomy in the surgical intensive care unit.

Author information

1
Grand Rapids/Michigan State University General Surgery Residency, Grand Rapids Medical Education and Research Center for the Health Professions, 221 Michigan St. N.E., Ste. 200-A, Grand Rapids, MI 49503, USA.

Abstract

BACKGROUND:

This study's purpose was to determine if early tracheostomy (ET) of severely injured patients reduces days of ventilatory support, the frequency of ventilator-associated pneumonia (VAP), and surgical intensive care unit (SICU) length of stay (LOS).

METHODS:

This 2-year retrospective review included 185 SICU patients with acute injuries requiring mechanical ventilation and tracheostomy. ET was defined as 7 days or less, and late tracheostomy (LT) as more than 7 days.

RESULTS:

The incidence of VAP was significantly higher in the LT group, relative to the ET group (42.3% vs. 27.2%, respectively; P <.05). Acute Physiology and Chronic Health Evaluation II scores, hospital and SICU LOS, and the number of ventilator days were significantly higher in the LT group.

CONCLUSIONS:

In patients who required prolonged mechanical ventilation, there was significant decreased incidence of VAP, less ventilator time, and lower ICU LOS when tracheostomy was performed within 7 days after admission to the SICU.

PMID:
15792753
DOI:
10.1016/j.amjsurg.2005.01.002
[Indexed for MEDLINE]

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