Early vs late tracheotomy in ICU patients.

摘要

Tracheotomy practice is variable in large part because what constitutes prolonged mechanical ventilation (ie, the optimal timing for tracheotomy) is not known.4 Defining and predicting the need for prolonged ventilation has been a major methodological challenge. Research on tracheotomy timing involves evaluating a 2-part study question. First, is it possible to pro-spectively identify patients who will require prolonged mechanical ventilation and could potentially benefit from tracheotomy? Second, does tracheotomy actually provide benefit for these patients? The key challenge is to avoid performing tracheotomy on patients who are close to extubation (ie, an unnecessary procedure) or who are not likely to survive (ie, a futile procedure), and instead find patients who might benefit.