To estimate time to wean from mechanical ventilation after tracheotomy in critically ill patients.
Prospective observational study in translaryngeally intubated mechanically ventilated patients that received a tracheostomy during their stay in an academic ICU.
Approximately 7% of all ICU-patients required a tracheostomy. Significant more tracheotomies were performed in neurosurgical/neurology patients and patients who were acutely admitted to the ICU (14% and 12%, respectively). Patients after cardiac arrest as the reason for the present ICU-admittance were tracheotomized in 15%. Tracheotomy was performed at a median time of 8 days (interquartile range, 4-13) after ICU-admittance. Within one week after tracheotomy, the probability of having breathed spontaneously without assist of the mechanical ventilator > 4 hours/day was 89%, 78% for > 8, 72% for > 12, and 60% for > 24 hours/day. By day 28, the probability of having breathed spontaneously > 4 hours/day was 98%, 97% for > 8, 94% for >12 and 93% for > 24 hours/day. Mean time to wean after tracheotomy was 5 days (2-11) for all patients. At day 7, 77% of the neurosurgery/neurology patients, 66% of cardiopulmonary surgery patients and 63% of the cardiology patients, but only 41% of surgical patients and 34% of medical patients were weaned completely from the mechanical ventilator.
Time to wean completely from mechanical ventilation after tracheotomy differs among the separate ICU-patient groups.
After tracheotomy, the majority of patients are quickly able to breathe spontaneously without assist of the mechanical ventilator for several hours/day.
Marcus Schultz, None.