PURPOSE: Obesity alters respiratory mechanics during mechanical ventilation which may complicate ventilator weaning. We hypothesized that physicians would preform tracheostomy earlier in obese patients than non-obese patients, and that obese patients would require prolonged tracheostomy compared with non-obese patients.
METHODS: A Reterospective chart review of all patients being admitted to the Medical or Surgical ICU’s and having a tracheostomy placed during the admission at a single tertiary care center. Key variables collected included length of time prior to tracheostomy, method used to preform tracheostomy, duration of tracheostomy and BMI.
RESULTS: We found that normal weight (BMI<25), overweight (25<BMI<30), and obese (BMI>30), had a similar duration of mechanical ventilation prior to trach. ((17.96 days(14.46-21.46) vs. 15.32 days (11.28-19.36) vs. 17.07 days (14.58-19.56) p=0.47). The overweight patients were the earliest to have tracheostomies placed. We also found that obese and non-obese patients had the trach in place for a similar duration of time (30.93 days (17.16-44.63) vs. 31.62 days (20.74-42.49) vs.34.87 days (26.24-43.49) p=0.93). There was also no difference between the groups in relation to the type of percutanous trachesotomy.
CONCLUSION: Though we had hypothesized the known complications of obesity would prompt earlier physician decision towards tracheostomy and prolonged weaning requiring a long duration with tracheostomy, this was not seen.
CLINICAL IMPLICATIONS: Our results suggest that body habitus does not affect physician decision regarding timing of tracheotomy, and in patients requiring prolonged mechanical ventilation, does not affect the duration of weaning as measured by the duration of trach placement.
DISCLOSURE: Laeeq Shamsuddin, None.