Early versus late tracheostomy in cardiovascular intensive care patients
| Autor: | Marcin Wąsowicz, G. Djaiani, Rosa Cabrerizo Sanchez, Angela Jerath, Wilfredo Puentes |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Critical Care medicine.medical_treatment Population 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Cohort Studies 03 medical and health sciences Postoperative Complications Tracheostomy 0302 clinical medicine Intensive care Atrial Fibrillation medicine Humans Hospital Mortality Renal Insufficiency Cardiac Surgical Procedures 030223 otorhinolaryngology education Aged Retrospective Studies education.field_of_study Rehabilitation business.industry Incidence Incidence (epidemiology) Retrospective cohort study Atrial fibrillation General Medicine Length of Stay Middle Aged medicine.disease Cardiac surgery Surgery Anesthesiology and Pain Medicine Cardiovascular Diseases Female Kidney Diseases business Cohort study |
| Zdroj: | Anestezjologia Intensywna Terapia. 48:89-94 |
| ISSN: | 1731-2531 1642-5758 |
| DOI: | 10.5603/ait.a2016.0016 |
| Popis: | Background: Benefits of tracheostomy have been well established. Most of the literature, refers these benefits to general intensive care population, excluding cardiac surgery or including only small number of these patients. On the other hand, there is no clear definition describing the proper time to perform the procedure and defining what are potential benefits of early compared to late tracheostomy. This retrospective cohort aims to assess the potential benefits of early tracheostomy on post-operative outcomes, length of stay and post-tracheostomy complications within cardiac surgical population. Methods: After obtaining REB approval, we conducted a retrospective chart review in a single, tertiary care institution, identifying patients who underwent tracheostomy after cardiac surgery from 1999 to 2006. Time-to-tracheostomy was defined as “early” if < 7 days or “late” if ≥ 7 days post-cardiac surgery). Results: 14,101 patients underwent cardiac surgery over the 7-year study period; from those, 147 (1.36%) received tracheostomy. 32 (22%) patients underwent early tracheostomy and 115 (78%) late tracheostomy. Incidence of atrial fibrillation (31.2% vs 61.7%; P = 0.003), kidney dysfunction (6.3% vs 27.2%; P =0.015) and kidney failure 18.8% vs 43.5%; P = 0.013) were lower in the early tracheostomy group. There were no differences on post tracheostomy infection or presence of acute respiratory distress syndrome. Both the ICU and hospital length of stay were significantly shorter in early tracheostomy group, 21.5 (ET) vs 36.9 (LT) days and 37.5 (ET) vs 57.6 (LT) days respectively. There were no differences in mortality between groups. Conclusions: There are significant benefits in reduction of postoperative morbidities with overall shorter ICU and hospital stay. These benefits may promote faster patient rehabilitation with reduced healthcare costs. |
| Databáze: | OpenAIRE |
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