The Practice, Outcome and Complications of Tracheostomy in Traumatic Brain Injury Patients in a Neurosurgical Intensive Care Unit: Surgical Versus Percutaneous Tracheostomy and Early Versus Late Tracheostomy

Overview

Journal Malays J Med Sci

Specialty General Medicine

Date 2022 Jul 18

PMID 35846499

Authors

Yusrina Zahari

Wan Mohd Nazaruddin Wan Hassan

Mohd Hasyizan Hassan

Rhendra Hardy Mohamad Zaini

Baharuddin Abdullah

Affiliations

Soon will be listed here.

Abstract

Background: The tracheostomy procedure is commonly required to wean patients off the severe traumatic brain injury (TBI). This study aimed to determine the practice, outcome and complications of two techniques: i) surgical tracheostomy (ST) versus percutaneous tracheostomy (PT) and ii) two different times of procedure: early tracheostomy (ET) versus late tracheostomy (LT).

Methods: This was a retrospective, cross-sectional study conducted from 1 January 2013 until 31 December 2017, involving 268 severe TBI patients who required tracheostomy during neurosurgical intensive care unit (Neuro-ICU) management. The data were obtained from their medical records.

Results: When based on techniques, PT displayed a significantly shorter day of tracheostomy plan (7.0 [2.5] versus 8.3 [2.6] days; < 0.001); day of execution (7.2 [2.6] versus 8.6 [2.9] days; < 0.001); duration of mechanical ventilation (9.8 [3.4] versus 11.3 [3.1] days; < 0.001) and duration of ICU stay (12.3 [3.7] versus 13.8 [3.5] days; < 0.003) than ST. If based on timing, ET showed a significantly shorter duration of mechanical ventilation (8.8 [2.1] versus 12.9 [2.9] days; < 0.001), length of ICU stay (11.4 [2.4] versus 15.2 [3.5] days; < 0.001) and length of hospital stay (17.1 [3.2] versus 20.0 [4.0] days; < 0.001) than LT.

Conclusion: PT showed a shorter mechanical ventilation and ICU stay duration than ST. In comparison, ET showed shorter mechanical ventilation, ICU stay and hospital stay duration than LT.

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