Early or late tracheotomy in patients after multiple organ trauma

• Authors: Łukasz Skrzypiec , Piotr Rot , Maciej Fus , Agnieszka Witkowska , Marcin Możański , Dariusz Jurkiewicz

Abstracts

EN

Introduction: Prolonged mechanical ventilation in patients after multiple organ trauma is an indication for a tracheotomy procedure being performed i.a. to ensure proper hygiene of patient’s airways. Recommendations regarding the optimum timing for the procedure remain ambiguous. Procedures performed before post-operative day 10 are beneficial for the further course of the treatment and patient’s health.
Aim: The main objective of the study was to analyze the relationship between the timing of tracheotomy and the length of mechanical ventilation in patients with multiple organ trauma. Secondary objectives included the assessment of the relationships between the timing of tracheotomy and the lengths of intensive care unit (ICU) stay and total hospitalization as well as the incidence of pneumonia and mortality.
Material and methods: A retrospective analysis was carried out in 543 patients in whom tracheotomy had been performed at the Clinical Intensive Care Unit of the Military Institute of Medicine in years 2015–2019. Patients were divided into two groups: (1) those subjected to early tracheotomy (prior to hospitalization day 10); and (2) those subjected to late tracheotomy (at day 10 or later).
Results: Duration of mechanical ventilation was shorter in patients subjected to early tracheotomy (by 20.3 days on average). The ICU stay and overall hospitalization lengths were also significantly shorter (by the average of 39.4 and 43.1 days, respectively). The mortality rate in patients subjected to early tracheotomy was lower (2%) than in those subjected to late tracheotomy (9%). Pneumonic complications were more common in patients subjected to tracheotomy at hospitalization day 10 or later.
Conclusions: Tracheotomy performed within up to 10 days of hospitalization significantly shortens the lengths of mechanical ventilation, ICU stay, and total hospitalization while simultaneously reducing the risk of pneumonia. No correlation has been observed between the timing of tracheotomy and patient mortality rates.

Keywords

EN

mechanical ventilation; multi-organ trauma; tracheotomy

• Publisher: Index Copernicus International
• Journal: Polish Journal of Otolaryngology
• Year: 2021
• Volume: 75
• Issue: 6
• Pages: 23-27

Dates

published

2021

Contributors

author

Łukasz Skrzypiec

• Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Medical Institute, Warsaw, Poland

author

Piotr Rot

• Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Medical Institute, Warsaw, Poland

author

Maciej Fus

• Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Medical Institute, Warsaw, Poland

author

Agnieszka Witkowska

• Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Medical Institute, Warsaw, Poland

author

Marcin Możański

• Department of Anaesthesiology and Intensive Therapy, Military Institute of Medicine, Central Clinical Hospital of the Ministry of National Defense, Warsaw, Poland

author

Dariusz Jurkiewicz

• Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Medical Institute, Warsaw, Poland

Identifiers

DOI

10.5604/01.3001.0015.0083

Biblioteka Nauki

23203232