Comparative study between outcome of early versus late tracheostomy for management of prolonged mechanically ventilated patients in ICU

Background and aim When a tracheotomy should be performed in critically ill patients on mechanical ventilation (MV) is an important clinical outcome-related concern. This research aimed to evaluate the effectiveness of early tracheostomy compared with late tracheostomy in the treatment of ICU patients who were mechanically ventilated. Patients and methods This prospective randomized controlled study involved 80 prolonged mechanically ventilated patients, aged 40–90 years, admitted to the ICU. Individuals were divided into two groups undergoing tracheostomy 4–6 days after MV (early) in group I and 13–15 days after endotracheal tube insertion (late) in group II. Results There were significantly higher APACHE II scores, incidences of ventilator-associated pneumonia, durations of MV in the ICU, lengths of hospital stays, and lengths of ICU stays in group II compared with group I ( P <0.001). There was no statistically significant difference between the two groups in terms of mortality, pneumothorax, hemorrhage, or tracheal ring fracture rates. Airway loss or esophageal perforation did not occur in any patient. Conclusions Compared with a late tracheostomy, an early one is associated with improved results in critically ill patients requiring MV. For example, there were fewer cases of ventilator-associated pneumonia, less MV time in ICU, shorter hospital stays, and shorter ICU stays overall.