title: [Impact of early elective tracheotomy in critically ill patients].
abstract: BACKGROUND
  Tracheotomy is one of the most frequent surgical procedures performed in critically ill patients hospitalized at intensive care units. The ideal timing for a tracheotomy is still controversial, despite decades of experience.
  
  
  OBJECTIVE
  To determine the impact of performing early tracheotomies in critically ill patients on duration of mechanical ventilation, intensive care unit stay, overall hospital stay, morbidity, and mortality.
  
  
  METHODS
  Retrospective and observational study of cases subjected to elective tracheotomy at one of the intensive care units of this hospital during five consecutive years. The patients were stratified into two groups: early tracheotomy group (tracheotomy performed from day one up to and including day seven of mechanical ventilation) and late tracheotomy group (tracheotomy performed after day seven). The outcomes of the groups were compared.
  
  
  RESULTS
  In the early tracheotomy group, there was a statistically significant reduction in duration of mechanical ventilation (6 days vs. 19 days; p<0.001), duration of intensive care unit stay (10 days vs. 28 days; p=0.001), and incidence of ventilator-associated pneumonia (1 case vs. 44 cases; p=0.001).
  
  
  CONCLUSIONS
  Early tracheotomy has a significant positive impact on critically ill patients hospitalized at this intensive care unit. These results support the tendency to balance the risk-benefit analysis in favor of early tracheotomy.
authors.affiliation: Hospital São José, Lisbon, Portugal. Electronic address: isabelmcorreia@gmail.com.
authors.forename: Isabel Araújo Marques
authors.initials: IA
authors.lastname: Correia
authors.affiliation: Hospital São José, Lisbon, Portugal.
authors.forename: Vítor
authors.initials: V
authors.lastname: Sousa
authors.affiliation: Hospital São José, Lisbon, Portugal.
authors.forename: Luis Marques
authors.initials: LM
authors.lastname: Pinto
authors.affiliation: Hospital São José, Lisbon, Portugal.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Barros
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*
keywords: Intensive care units; Intratracheal intubation; Intubação intratraqueal; Otorhinolaryngologic surgical procedures; Patologia cirúrgica; Procedimentos cirúrgicos otorrinolaringológicos