Ruohui Wang1, Changkun Pan2, Xiaokun Wang3, Feng Xu4, Shuang Jiang5, Ming Li6. 1. Department of ICU, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China. 2. Department of ICU, Jiamusi Tumour Hospital, Jiamusi, China. 3. Department of neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 4. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. 5. Department of ICU, Jiamusi Hospital of Chinese Medicine, Jiamusi, China. Electronic address: jiangshuang7799@sohu.com. 6. Department of ICU, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. Electronic address: liminghyd@sohu.com.
Abstract
BACKGROUND: The optimal timing of tracheotomy in critically ill ventilated patients remains controversial. OBJECTIVES: The objective of this meta-analysis was to assess tracheotomy timing for critically ill ventilated patients and determine the outcomes' reliability. METHODS: We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials. RESULTS: Compared with late tracheotomy, early tracheotomy presented a lower incidence of ventilator-associated pneumonia (VAP), shorter duration of mechanical ventilation (MV), and shorter intensive care unit (ICU) stay. However, trial sequential analysis (TSA), a kind of cumulative meta-analysis, indicated that the evidence was unreliable and inconclusive. CONCLUSIONS: The Findings suggest that early tracheotomy seems to be associated with a lower incidence of VAP, shorter duration of MV, shorter duration of sedation, and shorter ICU stay. However, the apparent benefits revealed in traditional meta-analysis contrast with the post-TSA results. More fully powered, randomized controlled trials focused on the outcomes of tracheotomy are highly warranted.
BACKGROUND: The optimal timing of tracheotomy in critically ill ventilated patients remains controversial. OBJECTIVES: The objective of this meta-analysis was to assess tracheotomy timing for critically ill ventilated patients and determine the outcomes' reliability. METHODS: We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials. RESULTS: Compared with late tracheotomy, early tracheotomy presented a lower incidence of ventilator-associated pneumonia (VAP), shorter duration of mechanical ventilation (MV), and shorter intensive care unit (ICU) stay. However, trial sequential analysis (TSA), a kind of cumulative meta-analysis, indicated that the evidence was unreliable and inconclusive. CONCLUSIONS: The Findings suggest that early tracheotomy seems to be associated with a lower incidence of VAP, shorter duration of MV, shorter duration of sedation, and shorter ICU stay. However, the apparent benefits revealed in traditional meta-analysis contrast with the post-TSA results. More fully powered, randomized controlled trials focused on the outcomes of tracheotomy are highly warranted.
Authors: Ismael A Salas De Armas; Kha Dinh; Bindu Akkanti; Pushan Jani; Reshma Hussain; Lisa Janowiak; Kayla Kutilek; Manish K Patel; Mehmet H Akay; Rahat Hussain; Jayeshkumar Patel; Chandni Patel; Yafen Liang; John Zaki; Biswajit Kar; Igor D Gregoric Journal: J Extra Corpor Technol Date: 2020-12
Authors: Brendan A McGrath; Michael J Brenner; Stephen J Warrillow; Vinciya Pandian; Asit Arora; Tanis S Cameron; José Manuel Añon; Gonzalo Hernández Martínez; Robert D Truog; Susan D Block; Grace C Y Lui; Christine McDonald; Christopher H Rassekh; Joshua Atkins; Li Qiang; Sébastien Vergez; Pavel Dulguerov; Johannes Zenk; Massimo Antonelli; Paolo Pelosi; Brian K Walsh; Erin Ward; You Shang; Stefano Gasparini; Abele Donati; Mervyn Singer; Peter J M Openshaw; Neil Tolley; Howard Markel; David J Feller-Kopman Journal: Lancet Respir Med Date: 2020-05-15 Impact factor: 30.700
Authors: Manuel Bernal-Sprekelsen; Francesc Xavier Avilés-Jurado; Julián Álvarez Escudero; César Aldecoa Álvarez-Santuyano; Candelaria de Haro López; Pedro Díaz de Cerio Canduela; Eduardo Ferrandis Perepérez; Carlos Ferrando Ortolá; Ricard Ferrer Roca; Alberto Hernández Tejedor; Fernando López Álvarez; Pablo Monedero Rodríguez; Andrea Ortiz Suñer; Pablo Parente Arias; Antonio Planas Roca; Guillermo Plaza Mayor; Pedro Rascado Sedes; Jon Alexander Sistiaga Suárez; Claudia Vera Ching; Rosa Villalonga Vadell; María Cruz Martín Delgado Journal: Acta Otorrinolaringol Esp (Engl Ed) Date: 2020-05-11
Authors: R Villalonga Vadell; M C Martín Delgado; F X Avilés-Jurado; J Álvarez Escudero; C Aldecoa Álvarez-Santuyano; C de Haro López; P Díaz de Cerio Canduela; E Ferrandis Perepérez; C Ferrando Ortolá; R Ferrer Roca; A Hernández Tejedor; F López Álvarez; P Monedero Rodríguez; A Ortiz Suñer; P Parente Arias; A Planas Roca; G Plaza Mayor; P Rascado Sedes; J A Sistiaga Suárez; C Vera Ching; R Villalonga Vadell; M C Martín Delgado; M Bernal-Sprekelsen Journal: Rev Esp Anestesiol Reanim (Engl Ed) Date: 2020-06-10
Authors: M C Martín Delgado; F X Avilés-Jurado; J Álvarez Escudero; C Aldecoa Álvarez-Santuyano; C de Haro López; P Díaz de Cerio Canduela; E Ferrandis Perepérez; C Ferrando Ortolá; R Ferrer Roca; A Hernández Tejedor; F López Álvarez; P Monedero Rodríguez; A Ortiz Suñer; P Parente Arias; A Planas Roca; G Plaza Mayor; P Rascado Sedes; J A Sistiaga Suárez; C Vera Ching; R Villalonga Vadell; M Bernal-Sprekelsen Journal: Med Intensiva (Engl Ed) Date: 2020-05-08