The impact of tracheotomy timing in critically ill patients undergoing mechanical ventilation: A meta-analysis of randomized controlled clinical trials with trial sequential analysis
| Autor: | Shuang Jiang, Ruohui Wang, Feng Xu, Changkun Pan, Ming Li, Xiaokun Wang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Critical Care Sedation medicine.medical_treatment Critical Illness 030204 cardiovascular system & hematology Cochrane Library Critical Care and Intensive Care Medicine law.invention 03 medical and health sciences 0302 clinical medicine Tracheotomy Randomized controlled trial law medicine Humans Randomized Controlled Trials as Topic Mechanical ventilation business.industry Intensive care unit Respiration Artificial Clinical trial 030228 respiratory system Meta-analysis Emergency medicine medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heartlung : the journal of critical care. 48(1) |
| ISSN: | 1527-3288 |
| Popis: | Background The optimal timing of tracheotomy in critically ill ventilated patients remains controversial. Objectives The objective of this meta-analysis was to assess tracheotomy timing for critically ill ventilated patients and determine the outcomes’ reliability. Methods We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials. Results Compared with late tracheotomy, early tracheotomy presented a lower incidence of ventilator-associated pneumonia (VAP), shorter duration of mechanical ventilation (MV), and shorter intensive care unit (ICU) stay. However, trial sequential analysis (TSA), a kind of cumulative meta-analysis, indicated that the evidence was unreliable and inconclusive. Conclusions The Findings suggest that early tracheotomy seems to be associated with a lower incidence of VAP, shorter duration of MV, shorter duration of sedation, and shorter ICU stay. However, the apparent benefits revealed in traditional meta-analysis contrast with the post-TSA results. More fully powered, randomized controlled trials focused on the outcomes of tracheotomy are highly warranted. |
| Databáze: | OpenAIRE |
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