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Báo cáo khoa học: "Early percutaneous dilatational tracheostomy leads to improved outcomes in critically ill medical patients as compared to delayed tracheostomy"

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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Early percutaneous dilatational tracheostomy leads to improved outcomes in critically ill medical patients as compared to delayed tracheostomy. | Available online at http ccforum.eom content 9 4 E12 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club EBM Journal Club Section Editor Eric B. Milbrandt MD MPH Journal club critique Early percutaneous dilatational tracheostomy leads to improved outcomes in critically ill medical patients as compared to delayed tracheostomy John C. Lee1 and Mitchell P. Fink2 1 Clinical Fellow Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 2 Professor and Chair Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA Published online 15 June 2005 This article is online at http ccform.com content 9 4 E12 2005 BioMed Central Ltd Critical Care 9 E12 DOI 10.1186 cc3759 Expanded Abstract Citation Rumbak MJ Newton M Truncale T Schwartz SW Adams JW Hazard PB A prospective randomized study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation delayed tracheotomy in critically ill medical patients. Crit Care Med 2004 32 1689-1694 1 . Hypothesis In the critically ill medical patients who are projected to require ventilation for 14 days early percutaneous tracheostomy within 48 hours of intubation offers significant survival advantage as well as decreased morbidity when compared with prolonged translaryngeal intubation delayed tracheostomy 14-16 days after intubation. Methods Design Prospective randomized trial. Setting Closed medical intensive care units of three academic medical centers in Memphis Tennessee and Tampa Florida. Subjects All patients in the three medical ICUs who were intubated and mechanically ventilated for acute respiratory failure were screened and included if they were 18 years old projected to need mechanical ventilation 14 days and had an initial APACHE II score 25. Specific exclusion criteria were established to ensure the safe performance of percutaneous tracheostomy .

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