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[Results of an artificial airway management protocol in critical patients subjected to mechanical ventilation].

Abstract：

OBJECTIVE:To determine the results of the implementation of a protocol in an intensive care unit (ICU) referred to critically ill patients requiring a prolonged artificial airway. DESIGN:A prospective, observational cohort study was carried out. INTERVENTION:Management strategies were established on the airway by endotracheal intubation (ETI) or tracheostomy, and guidelines were developed for action in the decannulation process. SETTING:A polyvalent ICU. PATIENTS:We studied 169 patients subjected to mechanical ventilation (MV), 67 with ETI ≥ 10 days of MV and 102 with percutaneous (PT) or surgical tracheostomy (TQ). VARIABLES OF INTEREST:ICU and hospital stays, days of ETI and MV, mortality, tracheostomy, anatomical risk factors, surgical complications, and postoperative decannulation period. RESULTS:ETI versus tracheotomy involved fewer days of MV (17 vs. 30 days, p<0.001), a shorter ICU stay (20 vs. 35 days, p<0.001), and a shorter hospital stay (34 vs. 51 days, p<0.001).There were more TQ procedures in patients with risk factors (47% TP vs. 89% TQ, p<0.001). Intraoperative minor bleeding was the most common complication, being associated with TQ (31% vs. 11%, p = 0.03). TP was associated with a shorter cannulationperiod (25 days vs. 34 days, p<0.04). CONCLUSIONS:The protocol variants showed no differences in terms of complications and mortality, when orienting application to patients with similar characteristics.

journal_name

Med Intensiva

journal_title

Medicina intensiva

authors

Prieto-González M,López-Messa JB,Moradillo-González S,Franzón-Laz ZM,Ortega-Sáez M,Poncela-Blanco M,Alonso-Castañeira I,Andrés-de Llano J

doi

10.1016/j.medin.2012.07.003

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

400-8

issue

6

eissn

0210-5691

issn

1578-6749

pii

S0210-5691(12)00232-X

journal_volume

37

pub_type

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