Effect of Tracheotomy Timing in Patients with Severe Cerebrovascular Disease

Peng-peng SUN; Zhi-jing LIU; Meng ZHANG; Jing-dong WANG; Sheng ZHANG; Lai-zang WANG; Peng BAI

doi:10.12259/j.issn.2095-610X.S20210816

Volume 42 Issue 8

Aug. 2021

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Article Navigation > Journal of Kunming Medical University > 2021 > 42(8): 90-94

Peng-peng SUN, Zhi-jing LIU, Meng ZHANG, Jing-dong WANG, Sheng ZHANG, Lai-zang WANG, Peng BAI. Effect of Tracheotomy Timing in Patients with Severe Cerebrovascular Disease[J]. Journal of Kunming Medical University, 2021, 42(8): 90-94. doi: 10.12259/j.issn.2095-610X.S20210816

Citation:

Peng-peng SUN, Zhi-jing LIU, Meng ZHANG, Jing-dong WANG, Sheng ZHANG, Lai-zang WANG, Peng BAI. Effect of Tracheotomy Timing in Patients with Severe Cerebrovascular Disease[J]. Journal of Kunming Medical University, 2021, 42(8): 90-94. doi: 10.12259/j.issn.2095-610X.S20210816

Citation:

Peng-peng SUN, Zhi-jing LIU, Meng ZHANG, Jing-dong WANG, Sheng ZHANG, Lai-zang WANG, Peng BAI. Effect of Tracheotomy Timing in Patients with Severe Cerebrovascular Disease[J]. Journal of Kunming Medical University, 2021, 42(8): 90-94. doi: 10.12259/j.issn.2095-610X.S20210816

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Effect of Tracheotomy Timing in Patients with Severe Cerebrovascular Disease

doi: 10.12259/j.issn.2095-610X.S20210816

1.
Dept. of Intensive Care Unit, Qingdao Center Medical Group，Affiliated with Qingdao University，Qingdao Shandong 266042
2.
Dept.of Pathology，Qingdao Municipal Hospital，Affiliated with Qingdao University，Qingdao Shandong 266071
3.
Dept.of Neurology，Zhejiang Provincial People’s Hospital，Hangzhou Zhejiang 310014
4.
Dept.of Neurosurgery，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2021-06-19
Available Online: 2021-08-03
Publish Date: 2021-08-04

Abstract

Abstract

Objective To evaluate the effect of tracheotomy at different time in patient with severe cerebrovascular disease. Methods A retrospective analysis was conducted on 56 patients with severe cerebrovascular disease who underwent tracheotomy in Qingdao Central Hospital Affiliated to Qingdao University from January 2018 to December 2020. All patients were divided into Early tracheotomy group [≤ 10 d Early tracheotomy （ET） group] and Late tracheotomy group [> 10 d Late tracheotomy （LT） group] based on the time of endotracheal intubation. Among them, 38 were male and 18 were female, aged 44-86 years. The basic characteristics, length of stay in intensive care unit （ICU） after tracheotomy, total length of stay in ICU, and the incidence of ventilator-associated pneumonia （VAP）, the duration of antibiotic use in patients with pulmonary infection, the incidence of multidrug resistance （MDR） in sputum culture and the distribution of bacterial flora in bacterial culture in the 2 groups were compared. Results There were no differences between the two groups in general characteristics, such as age, gender, acute physiology and chronic health evaluation Ⅱ（APACHEII）score and Glasgow coma scale （GCS） score （P > 0.05）. The incidence of VAP and the length of post-PDT ICU stay also showed no different between the two groups （P > 0.05）. However, in the early tracheotomy group, total ICU stay （median 15.5 and 22 d, respectively, P < 0.001）, duration of antibiotic use [（11.8±3.2） d and （17.1±4.1） d, respectively, P < 0.001] and the incidence of multiple drug resistance was significantly reduced compared with the late tracheotomy group （39% and 79%, respectively, P = 0.003）. The incidence of Klebsiella pneumoniae infection was lower in the early tracheotomy group （P = 0.029, respectively）. Conclusion ET in patients with severe cerebrovascular disease might contribute to a shorter duration of ICU length of stay, lower incidence of MDR, and shorter duration of antibiotic use. But ET does not reduce the incidence of VAP. Further assessment through effective methods is necessary for tracheotomy indication and timing.
- Tracheotomy timing,
- Severe cerebrovascular disease,
- Multidrug resistant

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References(19)

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