Prolonged mechanical ventilation in a respiratory-care setting: A comparison of outcome between tracheostomized and translaryngeal intubated patients

Yao Kuang Wu, Ying Huang Tsai, Chou Chin Lan, Chun Yao Huang, Chih Hsin Lee, Kuo Chin Kao, Jui Ying Fu

研究成果: 雜誌貢獻文章

21 引文 斯高帕斯(Scopus)

摘要

Introduction: Mechanical ventilation of patients may be accomplished by either translaryngeal intubation or tracheostomy. Although numerous intensive care unit (ICU) studies have compared various outcomes between the two techniques, no definitive consensus indicates that tracheostomy is superior. Comparable studies have not been performed in a respiratory care center (RCC) setting.Methods: This was a retrospective observational study of 985 tracheostomy and 227 translaryngeal intubated patients who received treatment in a 24-bed RCC between November 1999 and December 2005. Treatment and mortality outcomes were compared between tracheostomized and translaryngeal intubated patients, and the factors associated with positive outcomes in all patients were determined.Results: Duration of RCC (22 vs. 14 days) and total hospital stay (82 vs. 64 days) and total mechanical ventilation days (53 vs. 41 days) were significantly longer in tracheostomized patients (all P <0.05). The rate of in-hospital mortality was significantly higher in the translaryngeal group (45% vs. 31%;P <0.05). No significant differences were found in weaning success between the groups (both were >55%) or in RCC mortality. Because of significant baseline between-group heterogeneity, case-match analysis was performed. This analysis confirmed the whole cohort findings, except for the fact that a trend for in-hospital mortality was noted to be higher in the translaryngeal group (P = 0.08). Stepwise logistic regression revealed that patients with a lower median severity of disease (APACHE II score 2.5 g/dl) or had normal metabolism (BUN

原文英語
文章編號R26
期刊Critical Care
14
發行號2
DOIs
出版狀態已發佈 - 三月 1 2010
對外發佈Yes

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

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