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The impact of early percutaneous tracheotomy on reduction of the incidence of ventilator associated pneumonia and the course and outcome of ICU patients

MATEO PERIĆ ; Department of Anesthesia, Reanimation and Intensive care University Clinical Hospital Mostar Mostar, Bosnia and Hercegovina

Puni tekst: engleski pdf 166 Kb

str. 75-80

preuzimanja: 351



Te aim of the study. Te primary objective
of this study was to determine the
diferences in the incidence of respiratory
infections and septic episodes in patients
who underwent early percutaneous tracheotomy
(ET) and in patients who underwent
translaryngeal intubation i.e late tracheotomy
(LT). Secondary objectives were
to determine the diferences in the early
mortality of patients, duration of mechanical
ventilation and length of Intensive care
unit (ICU) stay.
Materials and methods. Te 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. Te basic criterion for inclusion
in the study was expected duration of
mechanical ventilation of at least 14 days.
Forty-eight hours afer enrollment, patients
were randomly divided into two groups.
Te frst group of patients underwent ET
afer 2-4 days of mechanical ventilation;
the second group underwent LT if they exhibited
longer episodes of hypoxemia afer
15 days.
Results. Te ET group of patients spent
less time in mechanical ventilation and
ICU. Te ET group had a lower rate of
VAS pneumonia (p=0.137), sepsis episodes
(p=0.029) and mortality rate (p=0.056).
Conclusion. Te results of our study support
ET being performed 2–4 days from
the start of mechanical ventilation. Despite
a lack of power, we found signifcant
benefts of ET regarding the incidence of
pneumonia, sepsis, hospital mortality, duration
of mechanical ventilation and length
of ICU stay.

Ključne riječi

tracheotomy, mechanical ventilation, intensive care unit, ventilator-associated pneumonia, treatment outcome, complication

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