Early tracheostomy versus late tracheostomy in the surgical intensive care unit

Am J Surg. 2005 Mar;189(3):293-6. doi: 10.1016/j.amjsurg.2005.01.002.


Background: This study's purpose was to determine if early tracheostomy (ET) of severely injured patients reduces days of ventilatory support, the frequency of ventilator-associated pneumonia (VAP), and surgical intensive care unit (SICU) length of stay (LOS).

Methods: This 2-year retrospective review included 185 SICU patients with acute injuries requiring mechanical ventilation and tracheostomy. ET was defined as 7 days or less, and late tracheostomy (LT) as more than 7 days.

Results: The incidence of VAP was significantly higher in the LT group, relative to the ET group (42.3% vs. 27.2%, respectively; P <.05). Acute Physiology and Chronic Health Evaluation II scores, hospital and SICU LOS, and the number of ventilator days were significantly higher in the LT group.

Conclusions: In patients who required prolonged mechanical ventilation, there was significant decreased incidence of VAP, less ventilator time, and lower ICU LOS when tracheostomy was performed within 7 days after admission to the SICU.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Critical Care*
  • Female
  • Humans
  • Length of Stay*
  • Male
  • Middle Aged
  • Pneumonia / etiology
  • Pneumonia / prevention & control*
  • Respiration, Artificial*
  • Retrospective Studies
  • Time Factors
  • Tracheostomy*
  • Ventilators, Mechanical / adverse effects