Effect Of Tracheostomy On the Weaning and Prognosis, in Respiratory Failure

Abstract

INTRODUCTION: To investigate the effect of tracheostomy on weaning and prognosis in patients undergoing long-term invasive mechanical ventilation (IMV) due to acute respiratory insufficiency. METHODS: The study was prospectively conducted on 24 tracheostomized T(+) and 26 non-tracheostomized T(-) patients who undergo long-term IMV due to acute respiratory insufficiency, between 2007-2009. RESULTS: The mean age of patients was 50+-18 in T(+) group and was 61+-18 years in T(-) group (p=0.04). The mean values of the APACHE II score on the first day were 22.25+-6 in the T(+) group and 27+-7 in the T(-) group, respectively (p=0.01). In T(+) group, the duration of intensive care and mechanical ventilation was longer than T(-) group, and the mean age and APACHE II score was lower (p0.05). In T(+) group, one patient developed transient tracheal stenosis and another one developed pneumothorax. The presence of acute renal failure (ARF) was associated with mortality, regardless of tracheostomy (P <0.05). In all patients, ≥23.5, the APACHE II score was related to mortality with 71% sensitivity and 68% specificity. DISCUSSION AND CONCLUSION: In conclusion, our study suggests that there is no a significant effect of tracheostomy on weaning and prognosis in patients undergoing of the long-term IMV. In patients with tracheostomy, intensive care and duration of mechanical ventilation are higher than those of patients without tracheostomy. Additionaly, ≥23.5 APACHE II scores and presence of ARF is associated with mortality regardless of tracheostomy.

Keywords

• prognosis
• respiratory insufficiency
• tracheostomy
• ventilator weaning