title: [Tracheostomy in French ICUs and patient outcome: national opinion survey].
abstract: OBJECTIVE
  Tracheostomy is a frequent procedure in ICU but patient follow-up and management after ICU has been poorly documented. We conducted a practice survey in French general ICUs and in neurointensive care units concerning tracheostomized ICU patients and their management after ICU.
  
  
  METHODS
  National observational descriptive transversal study as survey of opinion and practices.
  
  
  METHODS
  An email, with a link to an automated online questionnaire, was sent to two medical doctors of each French ICU. Demographic data and reported practices concerning indications, technique and post-ICU management were collected.
  
  
  RESULTS
  We received 148 intensivists responses from different ICUs, of which 15% from neurointensivists. There was no difference between general intensivists and neurointensivists concerning the reported use of tracheostomy (10±13% vs 20±22%, P=0.05) and concerning the usual timing of the procedure (predominantly between the 10th and the 21th day) (P=0.62). Indications were weaning failure from the ventilator and neurological ventilatory dysfunction. Percutaneous tracheostomy was mainly performed irrespective of the type of unit. Only 48% of doctors declared usually be able to wean patient from the cannula before ICU discharge. Usual difficulties for post-ICU transfer due only to the presence of the cannula were found by 80% of respondants. Eighty-nine per cent of respondents felt that management of tracheostomized patients after the ICU could be improved.
  
  
  CONCLUSIONS
  Tracheostomy is a frequent procedure, mostly percutaneous. Indications and timing for tracheostomy correspond to the recommendations. Reported difficulties in post-ICU management are important and present nationwide.
authors.affiliation: Département d'anesthésie-réanimation, neuroréanimation, CHU de Clermont-Ferrand, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: R
authors.initials: R
authors.lastname: Blondonnet
authors.affiliation: Département d'anesthésie-réanimation, neuroréanimation, CHU de Clermont-Ferrand, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France. Electronic address: rchabanne@chu-clermontferrand.fr.
authors.forename: R
authors.initials: R
authors.lastname: Chabanne
authors.affiliation: Département d'anesthésie-réanimation, neuroréanimation, CHU de Clermont-Ferrand, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: T
authors.initials: T
authors.lastname: Godet
authors.affiliation: Département d'anesthésie-réanimation, réanimation adultes & USCCHU Clermont-Ferrand, CHU Estaing, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Pascal
authors.affiliation: Délégation recherche clinique et innovation, unité de biostatistiques, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: B
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Département d'anesthésie-réanimation, neuroréanimation, CHU de Clermont-Ferrand, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: S
authors.initials: S
authors.lastname: Kauffmann
authors.affiliation: Département d'anesthésie-réanimation, réanimation adultes & USCCHU Clermont-Ferrand, CHU Estaing, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France; R2D2, EA 7281, université d'Auvergne, faculté de médecine, 63001 Clermont-Ferrand, France.
authors.forename: S
authors.initials: S
authors.lastname: Perbet
mesh_terms: D005602:France; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D010820:Physicians; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Brain-injured patients; Cérébrolésés; Enquête de pratique nationale; Intensive care unit; National practice survey; Réanimation; Tracheostomy; Trachéotomie