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Open AccessThe impact of early percutaneous tracheotomy on reduction of the incidence of ventilator associated pneumonia and the course and outcome of ICU patients
The impact of early percutaneous tracheotomy on reduction of the incidence of ventilator associated pneumonia and the course and outcome of ICU patients
1Department of Anesthesia, Reanimation and Intensive Care, University Clinical Hospital Mostar, Mostar, Bosnia and Hercegovina
2 University of Zagreb, School of medicine
*Corresponding Author(s): MATEO PERIĆ E-mail: mateo.peric@gmail.com
Abstract
The aim of the study. The primary objec-tive of this study was to determine the differences in the incidence of respiratory infections and septic episodes in patients who underwent early percutaneous trache-otomy (ET) and in patients who underwent translaryngeal intubation i.e late trache-otomy (LT). Secondary objectives were to determine the differences in the early mortality of patients, duration of mechani-cal ventilation and length of Intensive care unit (ICU) stay.
Materials and methods. The study included 72 surgical and trauma patients older than 18 years of age, treated at the ICU of the University Clinical Hospital Mostar who had undergone translaryngeal intubation and were mechanically ventilated for at least 48 hours. The basic criterion for inclu-sion in the study was expected duration of mechanical ventilation of at least 14 days. Forty-eight hours after enrollment, patients were randomly divided into two groups. The first group of patients underwent ET after 2-4 days of mechanical ventilation; the second group underwent LT if they ex-hibited longer episodes of hypoxemia after 15 days.
Results. The ET group of patients spent less time in mechanical ventilation and ICU. The ET group had a lower rate of VAS pneumonia (p=0.137), sepsis episodes (p=0.029) and mortality rate (p=0.056). Conclusion. The results of our study sup-port ET being performed 2–4 days from the start of mechanical ventilation. De-spite a lack of power, we found significant benefits of ET regarding the incidence of pneumonia, sepsis, hospital mortality, du-ration of mechanical ventilation and length of ICU stay
Keywords
tracheotomy, mechanical ventila-tion, intensive care unit, ventilator-associat-ed pneumonia, treatment outcome, compli-cations
Cite and Share
ZORAN KARLOVIĆ,DAJANA VLADIĆ,MATEO PERIĆ,MIRKO MIHALJ,ŽELJKA ZADRO,VIŠNJA MAJERIĆ-KOGLER. The impact of early percutaneous tracheotomy on reduction of the incidence of ventilator associated pneumonia and the course and outcome of ICU patients. Signa Vitae. 2018. 14(1);75-80.
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