Life advices in patients with tracheostomy: Rational antibiotic use and cerebro-vascular prophylaxis-physiotherapy

Tracheostomy is life-saving procedure in critical care patients which require long-term mechanical ventilation (MV) and an alternative to endotracheal intubation.(1,2) The factors affecting the survival of tracheostomized patients are not clearly known. The aim of this study was to investigate the factors affecting intensive care unit (ICU) and long-term mortality in the tracheostomized patients due to respiratory failure. A retrospective observational cohort study was planned between January 2016-2019 in tertiary ICU. Each patient underwent percutaneous and surgical tracheostomy was included. Demographic characteristics, diagnoses, causes of tracheostomy, comorbidities, Charlson and APACHE 2 scores, culture antibiogram results, ICU day and mortality (1-3 and 12 months) were recorded. In the analysis of the data, appropriate statistical tests and analyzes were used. 115 of 3620 patients admitted to tertiary ICU and underwent percutaneous and surgical tracheostomy due to respiratory failure between January 2016-2019 were included. 75 (65%) of the patients were male and median age was 68±14 years. Hospital mortality was higher in the group with Acinetobacter baumannii growth (p=0.04). According to Kaplan-Meier survival analysis, long-term follow-up of Acinetobacter baumanii growth did not affect survival (p=0.938). Patients with cerebro-vascular accident (CVA) had lower survival in long-term follow-up (p

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1. Blot F, Melot C; Commission d’Epidémiologie et de Recherche Clinique. Indications, timing, and techniques of tracheostomy in 152 French ICUs. Chest. 2005;127:347-52.

2. Durbin CG Jr. Tracheostomy: why, when, and how? Respir Care. 2010;55:1056-68. Review.

3. Yıldırım F, Güllü TY, Demirel BC. Yoğun bakımda peruktan trakeostomi. Eurasian J Pulmonol. 2015;17:136-41.

4. Liu Y, Di Y, Fu S. Risk factors for ventilator-associated pneumonia among patients undergoing major oncological surgery for head and neck cancer. Front Med. 2017;11:239-46.

5. Georges H, Leroy O, Guery B, et al. Predisposing factors for nosocomial pneumonia in patients receiving mechanical ventilation and requiring tracheotomy. Chest. 2000;118:767-74.

6. Rello J, Lorente C, Diaz E, et al. Incidence, etiology, and outcome of nosocomial pneumonia in ICU patients requiring percutaneous tracheotomy for mechanical ventilation. Chest. 2003;124:2239-43.

7. Aşık G. Acinetobacter baumannii Virülansının Açıklanmasında Güncel Yaklaşımlar. Mikrobiyol Bul. 2011;45:371-80.

8. Magdić Turković T, Obraz M, Zlatić Glogoški M, et al. Incidence, Etiology and Outcome of Ventilator-Associated Pneumonia in Patients with Percutaneous Tracheotomy. Acta Clin Croat. 2017;56:99-109.

9. Ibrahim EH, Tracy L, Hill C, et al. The occurrence of ventilator-associated pneumonia in a community hospital: risk factors and clinical outcomes. Chest. 2001;120:555-61.

10. Pawar M, Mehta Y, Khurana P, et al. Ventilator-associated pneumonia: Incidence, risk factors, outcome, and microbiology. J Cardiothorac Vasc Anesth. 2003;17:22-8.

11. Ambrosino N, Vagheggini G. Non-invasive ventilation in exacerbations of COPD. Int J Chron Obstruct Pulmon Dis. 2007;2:471–6.

12. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250–9.

13. Jefferson ND, Cohen AP, Rutter MJ. Subglottic stenosis. Semin Pediatr Surg. 2016;25:138-43.

14. Dion GR, Teng S, Bing R, et al. evelopment of anin vivo model of laryngeal burn injury. Laryngoscope. 2017;127:186-90.

15. Bagheri R, Rahim MB, Majidi M,et al. Anteriormediastinal tracheostomy for malignancy: analysis of 12 cases. Asian Cardiovasc Thorac Ann. 2013;21:187-92.

16. Miles A, McLellan N, Machan R, et al. Dysphagia and laryngeal pathology in post-surgical cardiothoracic patients. J Crit Care. 2018;45:121-7.

17. Boles JM, Bion J, Connors A, et al. Weaning from mechanical ventilation. Eur Respir J. 2007;29:1033-56.

18. Sheu CC, Tsai JR, Hung JY, et al. A simple modification of Ciaglia Blue Rhino technique for tracheostomy: using a guidewire dilating forceps for initial dilation. Eur J Cardiothorac Surg. 2007;31:114-9.

19. Byhahn C, Lischke V, Halbig S, et al. Ciaglia blue rhino: a modified technique for percutaneous dilatation tracheostomy. Technique and early clinical results. Anaesthesist. 2000;49:202-6. German.

20. Tamir SO, Khalaily N, Einav S, et al. 30-Day Morbidity and Mortality Rates in Elderly Subjects Following Surgical Tracheostomy. Respir Care. 2018;63:1009-15.

21. Siempos II, Ntaidou TK, Filippidis FT, et al. Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis. Lancet Respir Med. 2015;3:150-8.

22. Patel SA, Plowman EK, Halum S, et al. Late tracheotomy is associated with higher morbidity and mortality in mechanically ventilated patients. Laryngoscope. 2015;125:2134-8.

23. Papazian L, Bregeon F, Thirion X, et al. Effect of ventilator-associated pneumonia on mortality and morbidity. Am J Respir Crit Care Med. 1996;154:91-7.

24. Makris D, Desrousseaux B, Zakynthinos E, et al. The impact of COPD on ICU mortality in patients with ventilator-associated pneumonia. Respir Med. 2011;105:1022-9.

25. Di Pasquale M, Esperatti M, Crisafulli E, et al. Impact of chronic liver disease in intensive care unit acquired pneumonia: a prospective study. Intensive Care Med. 2013;39:1776-84.

26. 2Ranzani OT, Ferrer M, Esperatti M, et al. Association between systemic corticosteroids and outcomes of intensive care unit-acquired pneumonia. Crit Care Med. 2012;40:2552-61.

27. Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347-65.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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