EARLY VERSUS LATE TRACHEOSTOMY IN NEUROSURGERY ICU

430 views

Published on

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
430
On SlideShare
0
From Embeds
0
Number of Embeds
21
Actions
Shares
0
Downloads
0
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

EARLY VERSUS LATE TRACHEOSTOMY IN NEUROSURGERY ICU

  1. 1. Presenter: Ms Mary Teenu, Staff nurse, NIS, JPNATC Guide: Dr. Deepak Agrawal, Addl. Professor, Deptt of Neurosurgery, JPNATC
  2. 2. PROBLEM STATEMENT  A prospective randomized trial to compare early versus late tracheostomy in traumatic brain injury patients.
  3. 3. INTRODUCTION  A majority of patients with severe traumatic brain injury need ventilatory support and require endotracheal intubation.  Percutaneous tracheostomy is a common procedure in critically ill patients, but the correct timing is still controversial.
  4. 4. OPERATIONAL DEFINITION Early tracheostomy • Percutaneous tracheostomy when performed within 5 days of mechanical ventilation Late tracheostomy: • Percutaneous tracheostomy when performed after 5 days of mechanical ventilation
  5. 5. OBJECTIVES  To compare duration of ICU stay in early tracheostomy and late tracheostomy patients  To compare duration of ventilation in early tracheostomy and late tracheostomy patients  To compare mortality rate in early tracheostomy and late tracheostomy patients
  6. 6. RESEARCH DESIGN Quantitative Prospective Study
  7. 7. STUDY PERIOD 6 months (November 2012- April 2013)
  8. 8. SITE  All India Institute of Medical Sciences, New Delhi
  9. 9. SETTING  Neurosurgery ICU, JPNATC, AIIMS
  10. 10. SAMPLING METHOD Simple Random Sampling
  11. 11. POPULATION Traumatic brain injury patients who require mechanical ventilation
  12. 12. SAMPLE SIZE 50 traumatic brain injury patients who required mechanical ventilation
  13. 13. SUBJECT ALLOCATION  Out of the 50 subjects • (early tracheostomy)25 were in group A • (late tracheostomy)25 were in group B
  14. 14. INCLUSION CRITERIA  TBI patients who are admitted in neurosurgery ICU, JPNATC, AIIMS  TBI patients who require mechanical ventilation  Patients who are 18 years or above
  15. 15. EXCLUSION CRITERIA Patients below 18 years of age
  16. 16. RESULTS
  17. 17. MEAN AGE GROUPS Mean age (range) Group A 32.4 yrs (19-55yrs) Group B 30 yrs (20-54yrs) N=50
  18. 18. GENDER DISTRIBUTION 18 20 7 5 0 5 10 15 20 25 Group A (n=25) Group B (n=25) NUMBEROFMALESAND FEMALES Male Female 72% 28% 80% 20% N=50
  19. 19. AVERAGE DURATION OF ICU STAY 14.16 14.28 14.1 14.12 14.14 14.16 14.18 14.2 14.22 14.24 14.26 14.28 14.3 Group A (n=25) Group B (n=25) NUMBEROFDAYS Average duration of ICU stay Average duration of ICU stay N=50 p=0.14
  20. 20. AVERAGE DURATION OF VENTILATION Average duration of ventilation Group A (n=25) 12.45 DAYS Group B (n=25) 13.8 DAYS N=50 p=1.30
  21. 21. AVERAGE MORTALITY RATE Average mortality rate Group A (n=25) 2% Group B (n=25) 1% N=50
  22. 22. CONCLUSION  Early and late tracheostomy did not significantly differ in length of ICU stay, duration of ventilation and mortality rate  Further multicentre study should be conducted to further identify benefits of early tracheostomy
  23. 23. Thank you

×