Tracheostomy-related data from an intensive care unit for two consecutive years before the COVID-19 pandemic  

作　　者：Maria Papaioannou Evdoxia Vagiana Serafeim-Chrysovalantis Kotoulas Maria Sileli Katerina Manika Alexandros Tsantos Nikolaos Kapravelos 

机构地区：[1]1^(st)Intensive Care Unit,G Papanikolaou General Hospital,Exohi,Thessaloniki 57010,Greece [2]2^(nd)Intensive Care Unit,G Papanikolaou General Hospital,Exohi,Thessaloniki 57010,Greece [3]Intensive Care Unit,Hippokration General Hospital,Thessaloniki 54642,Greece [4]Department of Pulmonary,Medical School,Aristotle University of Thessaloniki,G.Papanikolaou General Hospital,Exohi,Thessaloniki 57010,Greece [5]2^(nd)Department of Internal Medicine,General Hospital of Thessaloniki“Ippokration”,Thessaloniki 54642,Greece

出　　处：《World Journal of Methodology》2024年第2期75-87,共13页世界方法学杂志

摘　　要：BACKGROUND Tracheostomy is commonly used in intensive care unit(ICU)patients who are expected to be on long-term mechanical ventilation or suffer from emergency upper airway obstruction.However,some studies have conflicting findings regarding the optimal technique and its timing and benefits.AIM To provide evidence of practice,characteristics,and outcome concerning tracheostomy in an ICU of a tertiary care hospital.METHODS This was a retrospective cohort study including adult critical care patients in a single ICU for two consecutive years.Patients’demographic characteristics,severity of illness(APACHE II score),level of consciousness[Glasgow Coma Scale(GCS)],comorbidities,timing and type of tracheostomy procedure performed and outcome were recorded.We defined late as tracheostomy placement after 8 days or no tracheotomy.RESULTS Data of 660 patients were analyzed(median age of 60 years),median APACHE II score of 19 and median GCS score of 12 at admission.Tracheostomy was performed in 115 patients,of whom 63 had early and 52 late procedures.Early tracheostomy was mainly executed in case of altered level of consciousness and severe critical illness polyneuromyopathy,however there were no significant statistical results(47.6%vs 36.5%,P=0.23)and(23.8%vs 19.2%,P=0.55)respectively.Regarding the method selected,early surgical tracheostomy(ST)was conducted in patients with maxillofacial injuries(50.0%vs 0.0%,P=0.033),whereas late surgical tracheostomy was selected for patients with goiter(44.4%vs 0.0%P=0.033).Patients with early tracheostomy spent significantly fewer days on mechanical ventilation(15.3±8.5 vs 22.8±9.6,P<0.001)and in ICU in general(18.8±9.1 vs 25.4±11.5,P<0.001).Percutaneous dilatation tracheostomy(PDT)vs ST was preferable in older critical care patients in the case of Central Nervous System underlying cause of admission(62.5%vs 26.3%,P=0.004).ST was the method of choice in compromised airway(31.6%,vs 7.3%P=0.008).A large proportion of patients(88/115)with tracheostomy managed to wean from mechanica

关 键 词：TRACHEOSTOMY Early tracheostomy Late tracheostomy Percutaneous dilatation tracheostomy Surgical tracheostomy WEANING Survival Mechanical ventilation 

分 类 号：R181.8[医药卫生—流行病学] C91[医药卫生—公共卫生与预防医学]