tailieunhanh - Báo cáo y học: "Prolonged mechanical ventilation in a respiratorycare setting: a comparison of outcome between tracheostomized and translaryngeal intubated patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Prolonged mechanical ventilation in a respiratorycare setting: a comparison of outcome between tracheostomized and translaryngeal intubated patients. | Wu et al. Critical Care 2010 14 R26 http content 14 2 R26 c CRITICAL CARE RESEARCH Open Access Prolonged mechanical ventilation in a respiratory-care setting a comparison of outcome between tracheostomized and translaryngeal intubated patients t t 1 113 Yao-Kuang Wu Ying-Huang Tsai Chou-Chin Lan Chun-Yao Huang Chih-Hsin Lee Kuo-Chin Kao Jui-Ying Fu 3 Abstract Introduction Mechanical ventilation of patients may be accomplished by either translaryngeal intubation or tracheostomy. Although numerous intensive care unit ICU studies have compared various outcomes between the two techniques no definitive consensus indicates that tracheostomy is superior. Comparable studies have not been performed in a respiratory care center RCC setting. Methods This was a retrospective observational study of 985 tracheostomy and 227 translaryngeal intubated patients who received treatment in a 24-bed RCC between November 1999 and December 2005. Treatment and mortality outcomes were compared between tracheostomized and translaryngeal intubated patients and the factors associated with positive outcomes in all patients were determined. Results Duration of RCC 22 vs. 14 days and total hospital stay 82 vs. 64 days and total mechanical ventilation days 53 vs. 41 days were significantly longer in tracheostomized patients all P . The rate of in-hospital mortality was significantly higher in the translaryngeal group 45 vs. 31 P . No significant differences were found in weaning success between the groups both were 55 or in RCC mortality. Because of significant baseline between-group heterogeneity case-match analysis was performed. This analysis confirmed the whole cohort findings except for the fact that a trend for in-hospital mortality was noted to be higher in the translaryngeal group P . Stepwise logistic regression revealed that patients with a lower median severity of disease APACHE II score 18 who were properly nourished albumin g dl or had normal .