COMPARACIÓN ENTRE TRAQUEOSTOMÍA TEMPRANA Y TARDÍA EN LOS PACIENTES CRÍTICOS HOSPITALIZADOS EN LA UNIDAD DE CUIDADOS INTENSIVOS DEL HOSPITAL LUIS VERNAZA. FEBRERO 2017 - FEBRERO 2018.

Abstract

Tracheostomy is a procedure that aims to establish a definitive airway in the critical patient (1). It is preferred to perform the tracheostomy in the first 7 days of intubation to reduce the complications related to intubation (2). Objectives: To determine if early tracheostomy improves the prognosis of critical patients in ICU. To compare the survival, mechanical ventilation time, hospital stay, and incidence of pneumonia in patients with an early tracheostomy. late tracheostomy. Design: Retrospective observational analytical study. Place: Intensive care unit of the Luis Vernaza Hospital, February 2017 to February 2018. Results: Of a total of 140 patients with tracheostomy, 37 belong to the early tracheostomy group and 103 to the late tracheostomy group. Statistically significant differences were found when comparing stay in ICU (27 vs. 34 days p = 0.013), total time of mechanical ventilation (17 vs. 22 days p = 0.002), pneumonia associated with mechanical ventilation 32% vs. 49% (n = 12 vs. 50). Survival of patients with early tracheostomy versus delayed tracheostomy visualized in the Kaplan-Meier curve does not find a significant difference at hospital discharge (p = 0.881). Conclusions: Early tracheostomy is associated with fewer days in the ICU and mechanical ventilation. It was not shown that early tracheostomy improves patient survival. Recommendations: Determine the predictive clinical factors to decide the performance of tracheostomy. Develop a management guide for the patient with a need for tracheostomy.