Rohit Bharti; Sindhu Sapru; Ponraj Kamatchi Sundaram; Ganesh Chauhan
Volume 9, Issue 4 , October 2021, , Pages 188-194
Abstract
Objective: To evaluate the impact of the early tracheostomy on operated patients with severe head injury. Methods: This prospective observational study was conducted at a level 1 trauma center and medical college over one-year period. The study included all surgically managed severe head injury patients ...
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Objective: To evaluate the impact of the early tracheostomy on operated patients with severe head injury. Methods: This prospective observational study was conducted at a level 1 trauma center and medical college over one-year period. The study included all surgically managed severe head injury patients without any other life-threatening major injuries. Patients who underwent tracheostomy within 7 days were classified as early tracheostomy. Results: The patient’s mean age of this cohort study was 43.4±14.5 years. Motor-vehicle accidents were being the most common cause of severe head injury. Operated patients were undergoing early tracheostomy on an average of 2.9 days. We were observed that the patients spent on a mechanical ventilation on an average 3.67±2.26 days. This was significantly lower than previous four published studies (p <0.05) which had a range of mean 9.8-15.7 days. Conclusion: We have shown that it is possible to decrease mechanical ventilation (MV) time, intensive care unit (ICU) stay and total hospital stay by doing early tracheostomy in operated severe head injury patients.
Veldurti Ananta Kiran Kumar; Narayanam Sai Kiran; Valluri Anil Kumar; Amrita Ghosh; Ranabir Pal; Vishnu Vardhan Reddy; Amit Agrawal
Volume 7, Issue 4 , October 2019, , Pages 355-360
Abstract
Objectives: To assess the impact, timing, the intra and early post-operative complications and the survival outcome of tracheostomy in critically ill neurosurgery patients. Methods: This study was a retrospective data mining where data was collected from hospital records from 175 consecutive patients ...
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Objectives: To assess the impact, timing, the intra and early post-operative complications and the survival outcome of tracheostomy in critically ill neurosurgery patients. Methods: This study was a retrospective data mining where data was collected from hospital records from 175 consecutive patients who underwent tracheostomy in the department of Neurosurgery at the Narayna Medical College Hospital, Nellore, India from Jan 2016 to April 2018. A proforma was used to note down the details on the patient status before and after tracheostomy: Glasgow coma scale (GCS), procedure and intra and post-operative complications, type of tracheostomy cannula, details of decannulation, respiration difficulties, and problems with wound, swallowing difficulties, and voice difficulties, stay in intensive care unit (ICU) and hospital and survival status of the patient. Results: In our series, mean age of TBI cases was 47.42±16.62; mean hospital stay and ICU stay was 18.81±10.22 and 12.58±7.36 days respectively. In all age groups, more tracheostomy was needed in cranial injury cases and surgery was major intervention. Commoner complications were mucous deposition (6.86%), blockage of tracheostomy canula (6.29%), bleeding from multiple attempts (6.06%), excessive bleeding (2.94%). Cranial injury needed tracheostomy more in all age groups and more done at operation theatre without significant improvement of GCS score. Survival was statistically higher after tracheostomy irrespective of GCS status or venue of intervention. Conclusion: Tracheostomy should be considered as soon as the need for airway access is identified during intervention of the critically ill neurosurgical patients.
Shahram Paydar; Hosseinali Khalili; Seyed Mohsen Mousavi
Volume 2, Issue 3 , July 2014, , Pages 136-137
Bijan Ziaeian; Sedigheh Tahmasebi; Hadi Niakan; Afsoun Fazelzadeh
Volume 1, Issue 3 , July 2013, , Pages 112-115
Abstract
Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent ...
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Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent tracheostomy during their ICU stay. The patients were categorized into two groups of the early tracheostomy who underwent tracheostomy within the first 7 days of initiation of mechanical ventilation (n=60), and the late tracheostomy group, in which tracheostomy was performed after 7 days (n=60). The duration of mechanical ventilation, ICU stay and hospital stay as well as mortality rates in ICU and hospital were recorded and compared between two study groups.Results: The baseline characteristics such as age (p=0.325), sex (p=0.071), Glasgow coma scale (GCS) (p=0.431) and the mechanism of injury (p=0.822) were comparable between two study groups. Early tracheostomy was associated with a significantly shorter duration of mechanical ventilation (p=0.008) and shorter ICU stay (p=0.003). Hospital stay (p=0.165), ICU mortality (p=0.243), and hospital mortality (p=0.311) were not different between the two study groups.Conclusion: Early tracheostomy is associated with reduced ICU stay and shorter duration of mechanical ventilation. Adopting a standardized strategy may improve resource utilization.
