Correlation between timing of tracheostomy and duration of mechanical ventilation in patients with potentially normal lungs admitted to intensive care unit

Authors
Mehrdad Masoudifar 1
Omid Aghadavoudi 2
Lida Nasrollahi 1
1 Department of Anesthesiology and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran
2 Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: There is insufficient evidence to conclude that the timing of tracheostomy alters the duration of mechanical ventilation, hence this study was designed to investigate the correlation between timing of tracheostomy and duration of mechanical ventilation for patients admitted to intensive care unit (ICU) with potentially normal lungs.
Materials and Methods: In a retrospective study for a period of 2 years, all adult patients admitted to the medical ICU of Al-Zahra Hospital in Isfahan University of Medical Sciences who needed endotracheal intubation and prolonged mechanical ventilation were considered for inclusion in this study. Data of underlying disease, causes of respiratory failure, age and gender, duration of mechanical ventilation, and interval between intubation time and tracheostomy were collected. The correlations between intubation period and ventilation period were analyzed using a Pearson correlation test.
Results: Sixty-six percent of patients (100 patients) were men. The mean ± SD of age of patients was 56.2 ± 20.8 years (18-90 years.). The timing of tracheostomy (duration of endotracheal intubation until tracheostomy) did not exhibit any correlation with the length of mechanical ventilation ( P = 0.43, r = 0.08). The timing of tracheostomy had not any correlation with the age of patients ( P = 0.20, r = 0.129). The length of mechanical ventilation had not any correlation with the age of patients ( P = 0.83, r = 0.02). The timing of tracheostomy was similar in men and women ( P = 0.5). Mechanical ventilation period was not significantly different in both genders ( P = 0.89).
Conclusion: Our study with mentioned sample size could not show any relationship between timing of tracheostomy and duration of mechanical ventilation in patients under mechanical ventilation with good pulmonary function in ICU.

Keywords

1. Esteban A, Anzueto A, Alia I, Gordo F, Apezteguia C, Palizas F, et al. How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J Respir Crit Care Med 2000;161:1450-8.  Back to cited text no. 1
    
2. Ahmed N, Kuo YH. Early versus late tracheostomy in patients with severe traumatic head injury. Surg Infect (Larchmt) 2007;8:343-7.  Back to cited text no. 2
[PUBMED]    
3. Arabi YM, Alhashemi JA, Tamim HM, Esteban A, Haddad SH, Dawood A, et al. The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients. J Crit Care 2009;24:435-40.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4. Kahveci SF, Goren S, Kutlay O, Ozcan B, Korfali G. Bedside percutaneous tracheostomy experience with 72 critically ill patients. Eur J Anaesthesiol 2000;17:688-91.  Back to cited text no. 4
[PUBMED]    
5. Hsu CL, Chen KY, Chang CH, Jerng JS, Yu CJ, Yang PC. Timing of tracheostomy as a determinant of weaning success in critically ill patients: A retrospective study. Crit Care 2005;9:R46-52.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6. MacIntyre NR, Cook DJ, Ely EW Jr, Epstein SK, Fink JB, Heffner JE, et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: A collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest 2001;120(6 Suppl):375S-95S.  Back to cited text no. 6
    
7. Romero J, Vari A, Gambarrutta C, Oliviero A. Tracheostomy timing in traumatic spinal cord injury. Eur Spine J 2009;18:1452-7.  Back to cited text no. 7
[PUBMED]  [FULLTEXT]  
8. Bsel J, Schiller P, Hacke W, Steiner T. Benefits of early tracheostomy in ventilated stroke patients? Current evidence and study protocol of the randomized pilot trial SETPOINT (Stroke-related Early Tracheostomy vs. Prolonged Orotracheal Intubation in Neurocritical care Trial). Int J Stroke 2012;7:173-82.  Back to cited text no. 8
    
9. Koch T, Hecker B, Hecker A, Brenck F, Preuß M, Schmelzer T, et al. Early tracheostomy decreases ventilation time but has no impact on mortality of intensive care patients: A randomized study. Langenbecks Arch Surg 2012.  Back to cited text no. 9
    
10. Mascia L, Terragni P. Tracheostomy in ICU patients: Question of timing is question of indication. Minerva Anestesiol 2011;77:1137-8.  Back to cited text no. 10
[PUBMED]  [FULLTEXT]  
11. Diehl JL, El Atrous S, Touchard D, Lemaire F, Brochard L. Changes in the work of breathing induced by tracheotomy in ventilator-dependent patients. Am J Respir Crit Care Med 1999;159:383-8.  Back to cited text no. 11
[PUBMED]  [FULLTEXT]  
12. Ibrahim EH, Tracy L, Hill C, Fraser VJ, Kollef MH. The occurrence of ventilator-associated pneumonia in a community hospital. Chest 2001;120:555-61.  Back to cited text no. 12
[PUBMED]  [FULLTEXT]  
13. Kollef MH, Ahrens TS, Shannon W. Clinical predictors and outcomes for patients requiring tracheostomy in the intensive care unit. Crit Care Med 1999;27:1714-20.  Back to cited text no. 13
[PUBMED]  [FULLTEXT]  
14. Brook AD, Sherman G, Malen J, Kollef MH. Early versus late tracheostomy in patients who require prolonged mechanical ventilation. Am J Crit Care 2000;9:352-9.  Back to cited text no. 14
[PUBMED]    
15. Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest 1989;96:178-80.  Back to cited text no. 15
[PUBMED]  [FULLTEXT]  
Advanced Biomedical Research
Volume 2012, July
July 2012
Pages 1-4