Early tracheostomy in trauma patients

Kluger, Yoram; Paul, D B; Lucke, Jacinta A.; Cox, Paul M.; Colella, Joseph J.; Townsend, Rob; Raves, John J.; Diamond, D L

doi:10.1097/00063110-199606000-00007

Cited by 87 publications

(58 citation statements)

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“…When patients with C-SCI are taken to hospital, doctors must judge those requiring tracheostomy and then perform the tracheostomy as soon as possible [4,5,13,16,20,21]. The benefits of tracheostomy have been discussed previously: improved secretion control, lower rates of pulmonary infection and laryngeal injury, the ability to be given oral nutrition, and shorter hospital/intensive care unit stays [4,13,16,20].…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of tracheostomy have been discussed previously: improved secretion control, lower rates of pulmonary infection and laryngeal injury, the ability to be given oral nutrition, and shorter hospital/intensive care unit stays [4,13,16,20]. An early tracheostomy maximizes these benefits, makes increased patient mobilization possible and minimizes the cost of hospitalization [4,21].…”

Section: Discussionmentioning

confidence: 99%

“…Tracheostomy provides a secure airway, facilitates secretion control and decreases the risk of pulmonary complications in C-SCI patients [4,5,6,11,13,15,16,20,21]. It has been reported that 21-77 % of patients with C-SCI require tracheostomy [6,11,13,15,21].…”

Section: Introductionmentioning

confidence: 99%

“…It has been reported that 21-77 % of patients with C-SCI require tracheostomy [6,11,13,15,21]. Early tracheostomy has been advocated from the viewpoint of medical economics and the patient's prognosis because it decreases the length of the hospital/intensive care unit stay and the rate of infectious complications, and increases the patient's ventilation tolerance [4,5,13,16,20,21]. However, quick identification of the risk factors associated with tracheostomy for each patient is necessary for early tracheostomy, but the identification process is difficult.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing the need for tracheostomy placement and decannulation after cervical spinal cord injury

et al. 2013

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Purpose There have been few reports on the risk factors for tracheostomy and the possibility of patients for decannulation. The purpose of this study was to identify factors necessitating tracheostomy after cervical spinal cord injury (SCI) and detect features predictive of successful decannulation in tracheostomy patients. Methods One hundred and sixty four patients with cervical fracture/dislocation were retrospectively reviewed. The patients comprised 142 men and 22 women with a mean age of 44.9 years. The clinical records were reviewed for patients' demographic data, smoking history, level of cervical spine injury, injury patterns, neurological status, evidence of direct thoracic trauma and head injury, tracheostomy placement, and decannulation. Risk factors necessitating tracheostomy and factors predicting decannulation were statistically analysed. Results Twenty-five patients (15.2 %) required tracheostomy. Twenty-one patients were successfully decannulated. Smoking history (relative risk [RR], 3.05; p = 0.03) and complete SCI irrespective of injury level (C1-4 complete SCI: RR, 67.55; p \ 0.001, C5-7 complete SCI: RR, 57.88; p \ 0.001) were significant risk factors necessitating tracheostomy. C1-4 complete SCI was more frequent among those who could not be decannulated. However, even in patients with high cervical complete SCI at the time of injury, patients regaining sufficient movement to shrug their shoulders within 3 weeks after injury could later be decannulated. Conclusions The risk factors for tracheostomy after complete SCI were a history of smoking and complete paralysis irrespective of the level of injury. High cervical level complete SCI was found to be a risk factor for the failure of decannulation in patients without shoulder shrug within 3 weeks after injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characterizing the need for tracheostomy placement and decannulation after cervical spinal cord injury

et al. 2013

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“…Varios estudios 5,[8][9][10][11][12] han reportado que la realización temprana de una traqueostomía en pacientes seleccionados puede acortar el tiempo de VM y reducir la estadía en la Unidad de Cuidados Intensivos (UCI). Incluso algunos investigadores han encontrado una menor incidencia de neumonía asociada a VM y una reducción de la mortalidad 4,8,[12][13][14][15][16] . Un reciente metaanálisis reportó una reducción de los días de VM y estadía en la UCI con la realización de una traqueostomía temprana, sin embargo no pudo demostrar una menor incidencia de neumonía asociada a VM ni reducción de la mortalidad 17 .…”

Section: A R T í C U L O D E I N V E S T I G a C I ó Nunclassified