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Comparison of the Clinical Effects of Early and Late Percutaneous Tracheostomy Timing in Intensive Care Unit Patients

Year 2025, Volume: 35 Issue: 1, 196 - 202, 28.02.2025
https://doi.org/10.54005/geneltip.1583289

Abstract

Background/Aims: Percutaneous Tracheostomy (PT) is defined as early or late PT according to the time from the patient's intubation to the day of PT procedure. We aimed to evaluate the effects of early and late tracheostomy timing on the duration of mechanical ventilation, duration of intensive care unit stay, length of hospital stay, complications and mortality.
Methods: The files and hospital records of critically ill patients who underwent tracheostomy during their treatment in the Anesthesiology and Reanimation Intensive Care Unit (ICU) between March 1, 2023 and May 31, 2024 were retrospectively evaluated. Patients in whom tracheostomy was performed on the 10th day of intubation and before the 10th day were grouped as early tracheostomy, and patients in whom tracheostomy was performed after the 10th day were grouped as late tracheostomy.
Results: The study included 90 patients. The early tracheostomy group(n=45) was significantly younger than the late tracheostomy group (n=45). The mean age of the early tracheostomy group was 62.42 ± 16.78, while that of the late tracheostomy group was 69.58 ± 16.20], (p=.043). The median ICU length of stay was 32 days (range: 6 – 270 days) in the early tracheotomy group and 45 days (range: 16 – 270 days) in the late tracheotomy group; and the ICU length of stay in the early tracheotomy group was significantly shorter than the late tracheotomy group (p=.025). Besides, the number of mechanical ventilation time was significantly greater in patients to the late tracheotomy group compared with patients to the early tracheotomy group (32 days [range: 6 – 230 days] vs. 40 days [range: 16 – 265 days], p=.032).
Conclusions: Early tracheostomy procedure is important and beneficial for the treatment of elderly intensive care patients because it reduces the duration of ICU stay and reduces the duration of mechanical ventilation.

Ethical Statement

The protocol of this study was approved by the Clinical Research Ethics Committee of Konya Selçuk University (No: 2024/436, 30 July 2024 ).

Supporting Institution

This study was supperted by Selçuk University Scientific Research Projects Coordination Unit (BAP).

Project Number

24401192

Thanks

We thank forever for the Coordination Office of Scientific Research Projects (BAP) of Selçuk University (BAP’s Project No: 24401192).

References

  • 1. Tekin P, Bulut A. Tracheostomy Timing in Unselected Critically Ill Patients with Prolonged Intubation: A Prospective Cohort Study. J Clin Med 2024;13(10):2729.
  • 2. Vudatha V, Alwatari Y, Ibrahim G, Jacobs T, Alexander K, Puig-Gilbert C, et al. Percutaneous Dilatational Tracheostomy in a Cardiac Surgical Intensive Care Unit: A Single-Center Experience. J Chest Surg 2023;56(5):346.
  • 3. Marinaki C, Kapadochos T, Katsoulas T, Rubbi I, Liveri A, Stavropoulou A, et al. Early versus late Tracheostomy promotes weaning in intensive care unit patients. Acta Biomed 2022;93(Suppl 2).
  • 4. Bickenbach J, Fries M, Offermanns V, Von Stillfried R, Rossaint R, Marx G, et al. Impact of early vs. late tracheostomy on weaning: a retrospective analysis. Minerva Anestesiol 2011;77(12):1176-83.
  • 5. Edipoğlu İS, Özcan PE, Akıncı Öİ, Yornuk M, Orhun G, Şentürk E, et al. Yoğun Bakım Hastalarında Erken ve Geç Trakeostomi Uygulamalarının Değerlendirilmesi. J Turk Soc Intens Care. Türk Yoğun Bakım Derneği Dergisi 2013;11: 60-3.
  • 6. Li C, Wang T, Sheng D, Zhang M, Zheng M, Li X. Association Between Timing of Percutaneous Dilatational Tracheotomy and Clinical Outcomes of Critically-ill Elderly Patients. J Coll Physicians Surg Pak 2024;20:12.4.
  • 7. Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB, et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. Jama 2010;303(15):1483-9.
  • 8. Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest. 1989;96(1):178-80.
  • 9. Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. Bmj. 2005;330(7502):1243.
  • 10. Samiei Nasr D, Khoundabi B, Monshizadeh Azar G, Malekmohammad M, Jamaati H, Hashemian SM. Beneficial outcomes of early tracheostomy in patients requiring prolonged mechanical ventilation. TANAFFOS (Respiration). 2020;19(4):350-5.
  • 11. Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med. 2004;32(8):1689-94.
  • 12. Tang Y, Wu Y, Zhu F, Yang X, Huang C, Hou G, et al. Tracheostomy in 80 COVID-19 patients: a multicenter, retrospective, observational study. Front Med (Lausanne). 2020;7:615845. 13. Añón JM, Gómez V, Escuela MP, De Paz V, Solana LF, De La Casa RM, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care. 2000;4:1-5. 14. Pietkiewicz P, Machała W, Kuśmierczyk K, Miłoński J, Wiśniewski T, Urbaniak J, et al. Early complications of Griggs percutaneous tracheotomy in own material. Otolaryngol Pol. 2012;66(3):196-200.
Year 2025, Volume: 35 Issue: 1, 196 - 202, 28.02.2025
https://doi.org/10.54005/geneltip.1583289

Abstract

Project Number

24401192

References

  • 1. Tekin P, Bulut A. Tracheostomy Timing in Unselected Critically Ill Patients with Prolonged Intubation: A Prospective Cohort Study. J Clin Med 2024;13(10):2729.
  • 2. Vudatha V, Alwatari Y, Ibrahim G, Jacobs T, Alexander K, Puig-Gilbert C, et al. Percutaneous Dilatational Tracheostomy in a Cardiac Surgical Intensive Care Unit: A Single-Center Experience. J Chest Surg 2023;56(5):346.
  • 3. Marinaki C, Kapadochos T, Katsoulas T, Rubbi I, Liveri A, Stavropoulou A, et al. Early versus late Tracheostomy promotes weaning in intensive care unit patients. Acta Biomed 2022;93(Suppl 2).
  • 4. Bickenbach J, Fries M, Offermanns V, Von Stillfried R, Rossaint R, Marx G, et al. Impact of early vs. late tracheostomy on weaning: a retrospective analysis. Minerva Anestesiol 2011;77(12):1176-83.
  • 5. Edipoğlu İS, Özcan PE, Akıncı Öİ, Yornuk M, Orhun G, Şentürk E, et al. Yoğun Bakım Hastalarında Erken ve Geç Trakeostomi Uygulamalarının Değerlendirilmesi. J Turk Soc Intens Care. Türk Yoğun Bakım Derneği Dergisi 2013;11: 60-3.
  • 6. Li C, Wang T, Sheng D, Zhang M, Zheng M, Li X. Association Between Timing of Percutaneous Dilatational Tracheotomy and Clinical Outcomes of Critically-ill Elderly Patients. J Coll Physicians Surg Pak 2024;20:12.4.
  • 7. Terragni PP, Antonelli M, Fumagalli R, Faggiano C, Berardino M, Pallavicini FB, et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. Jama 2010;303(15):1483-9.
  • 8. Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest. 1989;96(1):178-80.
  • 9. Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. Bmj. 2005;330(7502):1243.
  • 10. Samiei Nasr D, Khoundabi B, Monshizadeh Azar G, Malekmohammad M, Jamaati H, Hashemian SM. Beneficial outcomes of early tracheostomy in patients requiring prolonged mechanical ventilation. TANAFFOS (Respiration). 2020;19(4):350-5.
  • 11. Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med. 2004;32(8):1689-94.
  • 12. Tang Y, Wu Y, Zhu F, Yang X, Huang C, Hou G, et al. Tracheostomy in 80 COVID-19 patients: a multicenter, retrospective, observational study. Front Med (Lausanne). 2020;7:615845. 13. Añón JM, Gómez V, Escuela MP, De Paz V, Solana LF, De La Casa RM, et al. Percutaneous tracheostomy: comparison of Ciaglia and Griggs techniques. Crit Care. 2000;4:1-5. 14. Pietkiewicz P, Machała W, Kuśmierczyk K, Miłoński J, Wiśniewski T, Urbaniak J, et al. Early complications of Griggs percutaneous tracheotomy in own material. Otolaryngol Pol. 2012;66(3):196-200.
There are 12 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Original Article
Authors

Yeşim Şerife Bayraktar 0000-0001-5156-7064

Project Number 24401192
Publication Date February 28, 2025
Submission Date November 11, 2024
Acceptance Date December 31, 2024
Published in Issue Year 2025 Volume: 35 Issue: 1

Cite

Vancouver Bayraktar YŞ. Comparison of the Clinical Effects of Early and Late Percutaneous Tracheostomy Timing in Intensive Care Unit Patients. Genel Tıp Derg. 2025;35(1):196-202.

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