Factors related to tracheostomy timing and ventilator weaning: findings from a population in Northern Taiwan

Hui Chin Chen, Lixin Song, Hsin Chieh Chang, Min Tao Hsu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Determining the optimal time for performing a tracheostomy and weaning a patient off a ventilator is typically challenging for physicians, respiratory therapists, patients and patients' families. Purpose: This study examined the factors influencing tracheostomy timing and ventilator weaning and described the transition-care placement of patients who experience unsuccessful ventilator weaning. Methods: A retrospective design was employed, and 2 years of data were collected through a medical chart review performed at a hospital in Northern Taiwan. Sixty patients who received tracheostomies in the intensive care unit (ICU) or respiratory care center were enrolled. The data included each patient's demographic information, disease diagnosis, and Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II scores. Results: For patients on a ventilator in an ICU, the tracheostomy rate was 2.7%. Early (within 21 days) and late (>21 days) tracheostomies accounted for 36.7% and 63.3%, respectively. Of the patients who had received tracheostomies, 36.7% experienced ventilator weaning. The factors related to tracheostomy timing were disease diagnosis (P = 0.036) and days of ventilator use (P = 0.003). The factors related to ventilator weaning included disease diagnosis (P = 0.010) and tracheostomy timing (P = 0.001). Early tracheostomies were 10.9 times more likely than late tracheostomies to result in ventilator weaning (95%CI =2.5–47.7, P = 0.002). Conclusions: Tracheostomy timing was strongly correlated with ventilator weaning. Early tracheostomy was higher successful ventilator weaning rates. The surgical patients were more likely to receive an early tracheostomy. However, the number of patients in Taiwan who received tracheostomies was lower than that in other countries. Further study maybe need to understand cultural variations in the acceptance of tracheostomies by patients.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalClinical Respiratory Journal
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 1 2018
Externally publishedYes

Fingerprint

Ventilator Weaning
Tracheostomy
Taiwan
Population
Mechanical Ventilators
Intensive Care Units
Respiratory Center
Glasgow Coma Scale
APACHE

Keywords

  • respiratory care
  • timing
  • tracheostomy
  • ventilator weaning

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Genetics(clinical)

Cite this

Factors related to tracheostomy timing and ventilator weaning : findings from a population in Northern Taiwan. / Chen, Hui Chin; Song, Lixin; Chang, Hsin Chieh; Hsu, Min Tao.

In: Clinical Respiratory Journal, Vol. 12, No. 1, 01.01.2018, p. 97-104.

Research output: Contribution to journalArticle

@article{acceb84a68814a9ca1b646733bcf8a3d,
title = "Factors related to tracheostomy timing and ventilator weaning: findings from a population in Northern Taiwan",
abstract = "Introduction: Determining the optimal time for performing a tracheostomy and weaning a patient off a ventilator is typically challenging for physicians, respiratory therapists, patients and patients' families. Purpose: This study examined the factors influencing tracheostomy timing and ventilator weaning and described the transition-care placement of patients who experience unsuccessful ventilator weaning. Methods: A retrospective design was employed, and 2 years of data were collected through a medical chart review performed at a hospital in Northern Taiwan. Sixty patients who received tracheostomies in the intensive care unit (ICU) or respiratory care center were enrolled. The data included each patient's demographic information, disease diagnosis, and Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II scores. Results: For patients on a ventilator in an ICU, the tracheostomy rate was 2.7{\%}. Early (within 21 days) and late (>21 days) tracheostomies accounted for 36.7{\%} and 63.3{\%}, respectively. Of the patients who had received tracheostomies, 36.7{\%} experienced ventilator weaning. The factors related to tracheostomy timing were disease diagnosis (P = 0.036) and days of ventilator use (P = 0.003). The factors related to ventilator weaning included disease diagnosis (P = 0.010) and tracheostomy timing (P = 0.001). Early tracheostomies were 10.9 times more likely than late tracheostomies to result in ventilator weaning (95{\%}CI =2.5–47.7, P = 0.002). Conclusions: Tracheostomy timing was strongly correlated with ventilator weaning. Early tracheostomy was higher successful ventilator weaning rates. The surgical patients were more likely to receive an early tracheostomy. However, the number of patients in Taiwan who received tracheostomies was lower than that in other countries. Further study maybe need to understand cultural variations in the acceptance of tracheostomies by patients.",
keywords = "respiratory care, timing, tracheostomy, ventilator weaning",
author = "Chen, {Hui Chin} and Lixin Song and Chang, {Hsin Chieh} and Hsu, {Min Tao}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/crj.12492",
language = "English",
volume = "12",
pages = "97--104",
journal = "Clinical Respiratory Journal",
issn = "1752-6981",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Factors related to tracheostomy timing and ventilator weaning

T2 - findings from a population in Northern Taiwan

AU - Chen, Hui Chin

AU - Song, Lixin

AU - Chang, Hsin Chieh

AU - Hsu, Min Tao

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: Determining the optimal time for performing a tracheostomy and weaning a patient off a ventilator is typically challenging for physicians, respiratory therapists, patients and patients' families. Purpose: This study examined the factors influencing tracheostomy timing and ventilator weaning and described the transition-care placement of patients who experience unsuccessful ventilator weaning. Methods: A retrospective design was employed, and 2 years of data were collected through a medical chart review performed at a hospital in Northern Taiwan. Sixty patients who received tracheostomies in the intensive care unit (ICU) or respiratory care center were enrolled. The data included each patient's demographic information, disease diagnosis, and Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II scores. Results: For patients on a ventilator in an ICU, the tracheostomy rate was 2.7%. Early (within 21 days) and late (>21 days) tracheostomies accounted for 36.7% and 63.3%, respectively. Of the patients who had received tracheostomies, 36.7% experienced ventilator weaning. The factors related to tracheostomy timing were disease diagnosis (P = 0.036) and days of ventilator use (P = 0.003). The factors related to ventilator weaning included disease diagnosis (P = 0.010) and tracheostomy timing (P = 0.001). Early tracheostomies were 10.9 times more likely than late tracheostomies to result in ventilator weaning (95%CI =2.5–47.7, P = 0.002). Conclusions: Tracheostomy timing was strongly correlated with ventilator weaning. Early tracheostomy was higher successful ventilator weaning rates. The surgical patients were more likely to receive an early tracheostomy. However, the number of patients in Taiwan who received tracheostomies was lower than that in other countries. Further study maybe need to understand cultural variations in the acceptance of tracheostomies by patients.

AB - Introduction: Determining the optimal time for performing a tracheostomy and weaning a patient off a ventilator is typically challenging for physicians, respiratory therapists, patients and patients' families. Purpose: This study examined the factors influencing tracheostomy timing and ventilator weaning and described the transition-care placement of patients who experience unsuccessful ventilator weaning. Methods: A retrospective design was employed, and 2 years of data were collected through a medical chart review performed at a hospital in Northern Taiwan. Sixty patients who received tracheostomies in the intensive care unit (ICU) or respiratory care center were enrolled. The data included each patient's demographic information, disease diagnosis, and Glasgow Coma Scale score and Acute Physiology and Chronic Health Evaluation II scores. Results: For patients on a ventilator in an ICU, the tracheostomy rate was 2.7%. Early (within 21 days) and late (>21 days) tracheostomies accounted for 36.7% and 63.3%, respectively. Of the patients who had received tracheostomies, 36.7% experienced ventilator weaning. The factors related to tracheostomy timing were disease diagnosis (P = 0.036) and days of ventilator use (P = 0.003). The factors related to ventilator weaning included disease diagnosis (P = 0.010) and tracheostomy timing (P = 0.001). Early tracheostomies were 10.9 times more likely than late tracheostomies to result in ventilator weaning (95%CI =2.5–47.7, P = 0.002). Conclusions: Tracheostomy timing was strongly correlated with ventilator weaning. Early tracheostomy was higher successful ventilator weaning rates. The surgical patients were more likely to receive an early tracheostomy. However, the number of patients in Taiwan who received tracheostomies was lower than that in other countries. Further study maybe need to understand cultural variations in the acceptance of tracheostomies by patients.

KW - respiratory care

KW - timing

KW - tracheostomy

KW - ventilator weaning

UR - http://www.scopus.com/inward/record.url?scp=85042115885&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042115885&partnerID=8YFLogxK

U2 - 10.1111/crj.12492

DO - 10.1111/crj.12492

M3 - Article

C2 - 27162059

AN - SCOPUS:85042115885

VL - 12

SP - 97

EP - 104

JO - Clinical Respiratory Journal

JF - Clinical Respiratory Journal

SN - 1752-6981

IS - 1

ER -