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Early vs late trach: no diff

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4 papers 0 to 25 followers
By Jason Mann No BS pulmonary critical care fellow
Koji Hosokawa, Masaji Nishimura, Moritoki Egi, Jean-Louis Vincent
INTRODUCTION: The optimal timing of tracheotomy in critically ill patients remains a topic of debate. We performed a systematic review to clarify the potential benefits of early versus late tracheotomy. METHODS: We searched PubMed and CENTRAL for randomized controlled trials that compared outcomes in patients managed with early and late tracheotomy. A random-effects meta-analysis, combining data from three a priori-defined categories of timing of tracheotomy (within 4 versus after 10 days, within 4 versus after 5 days, within 10 versus after 10 days), was performed to estimate the weighted mean difference (WMD) or odds ratio (OR)...
December 4, 2015: Critical Care: the Official Journal of the Critical Care Forum
Damon C Scales, Deva Thiruchelvam, Alexander Kiss, Donald A Redelmeier
BACKGROUND: Tracheostomy is common in intensive care unit patients, but the appropriate timing is controversial. OBJECTIVE: To determine whether earlier tracheostomy is associated with greater long-term survival. DESIGN: Retrospective cohort analysis. SETTING: Acute care hospitals in Ontario, Canada (n = 114). PATIENTS: All mechanically ventilated intensive care unit patients who received tracheostomy between April 1, 1992 and March 31, 2004, excluding extreme cases (< 2 or > or = 28 days) and children (< 18 yrs)...
September 2008: Critical Care Medicine
Nora H Cheung, Lena M Napolitano
Tracheostomy is a common procedure performed in critically ill patients requiring prolonged mechanical ventilation for acute respiratory failure and for airway issues. The ideal timing (early vs late) and techniques (percutaneous dilatational, other new percutaneous techniques, open surgical) for tracheostomy have been topics of considerable debate. In this review, we address general issues regarding tracheostomy (epidemiology, indications, and outcomes) and specifically review the literature regarding appropriate timing of tracheostomy tube placement...
June 2014: Respiratory Care
Duncan Young, David A Harrison, Brian H Cuthbertson, Kathy Rowan
IMPORTANCE: Tracheostomy is a widely used intervention in adult critical care units. There is little evidence to guide clinicians regarding the optimal timing for this procedure. OBJECTIVE: To test whether early vs late tracheostomy would be associated with lower mortality in adult patients requiring mechanical ventilation in critical care units. DESIGN AND SETTING: An open multicentered randomized clinical trial conducted between 2004 and 2011 involving 70 adult general and 2 cardiothoracic critical care units in 13 university and 59 nonuniversity hospitals in the United Kingdom...
May 22, 2013: JAMA: the Journal of the American Medical Association
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