Download Tracheostomy – Journal Summaries

Tracheostomy – Journal Summaries
20/9/10
PY Mindmaps
PDT = Ciaglia Technique
1999 – Dulguerov et al, Critical Care Medicine
- open vs perc.
-> PDT+ Bronch = lowest complication rate in percutaneous group
- percutaneous group = lower post op but higher perioperative complication rate
2000 – Cheng et al, Ann Otol Rhinol Laryngol
- meta-analysis (including 4 RCT’s)
- open vs PDT
-> PDT = lower risk of infection and bleeding
-> PDT + Bronch as safe as open tracheostomy
2000 – Freeman et al, Chest
- meta-analysis (including 5 RCT’s)
- open vs PDT
-> no overall difference in mortality rate
-> PDT: quicker, lower post op complications, less bleeding
2006 - Delaney et al, Crit Care Med
- large meta-analysis (17 studies)
- PDT vs open
-> PDT: lower wound infection
-> no difference in bleeding and complication rates
2007 – Higgins et al, Laryngoscope
- PDT vs open
- meta-analysis (15 studies)
- PDT: less infection, less scarring, trend towards lower complication rate, faster, cheaper,
lower conversion rate
- PDT: higher accidental decannulation, no difference in bleeding, subglottic stenosis, death
Griffiths, J et al (2005) “Systematic review and meta-analysis of the timing of tracheostomy in
adult patients undergoing artificial ventilation” BMJ 330:1243-1247
- early vs later tracheostomy or prolonged ventilation
- n = 406
- 5 papers
-> no mortality difference
-> no difference in risk of pneumonia
-> significant decrease in duration of mechanical ventilation
-> significant decrease in duration of ICU stay
Jeremy Fernando (2010)