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EARLY VERSUS LATE TRACHEOSTOMY IN NEUROSURGERY ICU
1. Presenter: Ms Mary Teenu, Staff nurse, NIS, JPNATC
Guide: Dr. Deepak Agrawal, Addl. Professor, Deptt of Neurosurgery,
JPNATC
2. PROBLEM STATEMENT
A prospective randomized trial to compare
early versus late tracheostomy in traumatic
brain injury patients.
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. 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. 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
14. SUBJECT ALLOCATION
Out of the 50 subjects
• (early
tracheostomy)25 were in
group A
• (late
tracheostomy)25 were in
group B
15. 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
20. 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
21. 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
23. 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