Early postoperative alterations of ventilation parameters after tracheostomy in major burn injuries.
OBJECTIVE
In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS) plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS.


METHODS
A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered.


RESULTS
A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52+/-19 years. Mean abbreviated burned severity index (ABSI) was 8.3+/-2.2. A mechanical ventilation was required for 14.3+/-4.8 days. TS was performed on day 7+/-4. Inspiratory oxygen concentration (FiO(2)) (p<0.001), peak inspiratory pressure (p<0.001), positive end-expiratory pressure (p=0.003) and pulmonary resistance (p<0.001) were reduced significantly after TS. The arterial partial pressure of oxygen/FiO(2)-ratio increased significantly after TS (p<0.001).


CONCLUSIONS
We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.
Namdar
Thomas
T
Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany. thomas.namdar@uk-sh.de
Stollwerck
Peter Leonard
PL
Stang
Felix Hagen
FH
Klotz
Karl-Friedrich
KF
Lange
Thomas
T
Mailänder
Peter
P
Siemers
Frank
F
D000328:Adult; D000368:Aged; D000403:Airway Resistance; D002056:Burns / Q000601:surgery*; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000517:prevention & control*; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*; D012189:Retrospective Studies; D014139:Tracheostomy / Q000379:methods*; D015599:Trauma Severity Indices; D016896:Treatment Outcome