Mobilizing the patient in the intensive care unit: the role of early tracheotomy.
A large number of studies have evaluated the benefits of early tracheotomy. Heterogeneity in the various studies reviewed in this article is apparent, with early tracheotomy ranging from one to several days, and benefits regarding incidence of pneumonia and mortality are variable. An additional factor likely contributing to the differing results relates to the varied patient populations in the individual studies, which ranged from burn patients to medical ICU patients to trauma patients and head trauma patients. A close look at the studies with the least confounding variables suggests that early tracheotomy has some merit. Most studies suggest that time in the ICU, on mechanical ventilation, and in the hospital is reduced.
Clum
Stephen R
SR
Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Section of Interventional Pulmonology, University of South Florida College of Medicine, Tampa, FL 33612, USA.
Rumbak
Mark J
MJ
D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000534:rehabilitation*; D004434:Early Ambulation; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D007902:Length of Stay; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control; D012121:Respiration, Artificial; D013997:Time Factors; D014140:Tracheotomy / Q000009:adverse effects / Q000706:statistics & numerical data; D015300:Ventilator Weaning