Background: Tracheostomy is a common procedure in intensive care unit. It may potentially reduce the duration of mechanical ventilation. However, the impact of tracheostomy timing in critically ill patients, who are predicted to require long-term ventilatory support, on the duration of ventilator usage is still under debate. Objective: To investigate the association between tracheostomy timing with the duration of ventilatory support after tracheostomy.
Methods: Retrospective cohort study was conducted on 162 patients who underwent tracheostomy during intensive care treatment in Cipto Mangunkusumo Hospital (CMH) from January 2008 to December 2012. Patients were divided into 2 groups based on the timing of tracheostomy: early (before 10th day of mechanical ventilation) and late (on or after 10th day). Duration of total and post-tracheostomy mechanical ventilation was observed on all subjects. Among 162 subjects, 105 survivors were analyzed further on the correlation between tracheostomy timing and duration of post-tracheostomy mechanical ventilation. Mann-Whitney test was used in the analysis.
Results: Median duration of post-tracheostomy mechanical ventilation on all subjects was shorter in early tracheostomy group, which was 5 (1-62) days, compared to 7 (1-41) days in late tracheostomy group (p=0,06). Median duration of mechanical ventilation after tracheostomy on survivors was also shorter in early tracheostomy group, which was 3 days (6 hours-44 days), compared to 5 (1-41) days in late tracheostomy group (p=0,05). Conclusion: Survivors in early tracheostomy group has significantly shorter duration of post-tracheostomy mechanical ventilation compared with those of late tracheostomy group.
Keywords: Tracheostomy timing, early tracheostomy, late tracheostomy, mechanical ventilation duration