Effect of tracheotomy timing on patients receiving mechanical ventilation: A meta-analysis of randomized controlled trials.

Autor: Han R; Department of Otolaryngology, Weifang People's Hospital, Weifang, Shan dong Province, China., Gao X; Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shan dong Province, China., Gao Y; Urology Department I, Weifang Hospital of traditional Chinese Medicine, Weifang, Shan dong Province, China., Zhang J; Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shan dong Province, China., Ma X; Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shan dong Province, China., Wang H; Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shan dong Province, China., Ji Z; Department of Critical Care Medicine, Weifang People's Hospital, Weifang, Shan dong Province, China.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jul 23; Vol. 19 (7), pp. e0307267. Date of Electronic Publication: 2024 Jul 23 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0307267
Abstrakt: Purpose: We assessed the effects of tracheostomy timing (early vs. late) on outcomes among adult patients receiving mechanical ventilation.
Methods: PubMed, Embase, Web of Science and Cochrane Library were searched to identify relevant RCTs of tracheotomy timing on patients receiving mechanical ventilation. Two reviewers independently screened the literature, extracted data. Outcomes in patients with early tracheostomy and late tracheostomy groups were compared and analyzed. Meta-analysis was performed using Stata14.0 and RevMan 5.4 software. This study is registered with PROSPERO (CRD42022360319).
Results: Twenty-one RCTs were included in this Meta-analysis. The Meta-analysis indicated that early tracheotomy could significantly shorten the duration of mechanical ventilation (MD: -2.77; 95% CI -5.10~ -0.44; P = 0.02) and the length of ICU stay (MD: -6.36; 95% CI -9.84~ -2.88; P = 0.0003), but it did not significantly alter the all-cause mortality (RR 0.86; 95% CI 0.73~1.00; P = 0.06), the incidence of pneumonia (RR 0.86; 95% CI 0.74~1.01; P = 0.06), and length of hospital stay (MD: -3.24; 95% CI -7.99~ 1.52; P = 0.18).
Conclusion: In patients requiring mechanical ventilation, the tracheostomy performed at an earlier stage may shorten the duration of mechanical ventilation and the length of ICU stay but cannot significantly decrease the all-cause mortality and incidence of pneumonia.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Han et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje