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128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

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Early tracheostomy decreases ventilation time but has no impact on mortality of intensive care patients: A prospective randomized study

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  • Andreas Hecker - Universitätsklinikum Gießen, Klinik für Allgemein-, Viszeral-, Thorax-, Transplantationschirurgie, Gießen
  • Birgit Hecker - Universitätsklinikum Gießen, Klinik für Anästhesiologie & Intensivmedizin, Gießen
  • Tillo Koch - Universitätsklinikum Gießen, Klinik für Anästhesiologie & Intensivmedizin, Gießen
  • Winfried Padberg - Universitätsklinikum Gießen, Klinik für Allgemein-, Viszeral-, Thorax-, Transplantationschirurgie, Gießen
  • Joachim Klasen - Krankenhaus Kaufbeuren, Klinik für Anaesthesiologie & Intensivmedizin, Kaufbeuren
  • Markus Weigand - Universitätsklinikum Gießen, Klinik für Anästhesiologie & Intensivmedizin, Gießen

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch712

doi: 10.3205/11dgch712, urn:nbn:de:0183-11dgch7123

Published: May 20, 2011

© 2011 Hecker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Long-term ventilation in intensive care units is associated with several problems such as increased mortality, increased rates of ventilator associated pneumonia (VAP), prolonged time of hospitalization, and thus, leads to enormous financial consequences. While the influence of tracheostomy on VAP incidence, duration of ventilation, and time of hospitalization has already been analyzed in several studies, the timing of the tracheostomy procedure on patient’s mortality is still controversial. The aim of our study is to investigate whether early tracheostomy improved outcome in critically ill patients.

Materials and methods: Within 2 years, 100 critically ill, predominantly surgical patients entered this prospective randomized study. A percutaneous dilatational tracheostomy (PDT) was performed either early (£ 4 days, 2.8 days median) or late (³ 6 days, 8.1 days median) after intubation.

Results: We could demonstrate that mortality was not significantly reduced in the early tracheostomy (ET) group in contrast with the late tracheostomy (LT) group. But ET is associated with decreased VAP incidence (ET 38% vs. LT 64%), decreased duration of ventilation (ET 367.5 h vs LT 507.5 h) and shorter time of hospitalization both in hospital (ET 31.5 days vs LT 68 days) and on ICU (ET 21.5 days vs LT 27 days).

Conclusion: Despite of many advantages like reduced time of ventilation and hospitalization early tracheostomy is not associated with decreased mortality in critically-ill patients.