THE EFFECT OF EARLY VERSUS LATE TRACHEOSTOMY ON DURATION OF MECHANICAL VENTILATION AND INTENSIVE CARE UNIT STAY IN TRAUMATIC BRAIN INJURY PATIENTS

AbstractTracheostomy is a surgical procedure that frequently performed for patients in the intensive care units (ICUs). Prolonged mechanical ventilation (MV) is the main indication for tracheostomy in the ICU.This study aimed to compare the effect of early versus late tracheostomy on duration of mechanical ventilation and ICU length of stay in traumatic brain injury patients and to determine the appropriate timing to perform tracheostomy for those patients.A Prospective comparative study was performed for head trauma patients with Glasgow coma scale (GCS) less than eight who needed endotracheal intubation with or without mechanical ventilation in the ICU of Al-Sadr Teaching Hospital in Basrah from February 2019 up to December 2019.In this study, there were 94% males and 6% females, 52% were in the age group between 20-40 years, median duration on endotracheal tube in early tracheostomy (ET) group was 5 days while in late tracheostomy (LT) group was 11 days. Total duration on MV was significantly shorter in ET group (9.63±1.87 versus 17.81±6.66 days in LT group; p<0.05). Post tracheostomy MV duration was shorter in ET (6.23±1.48 versus 10.69±4.34 days p<0.05). The ICU length of stay also was significantly shorter in early group (12.70±1.80 versus 22.37±7.19 days; p<0.05).In conclusion; early tracheostomy in traumatic brain injury before 7 days from endotracheal intubation significantly shortens the duration of mechanical ventilation and ICU length of stay.Key words: early, late, tracheostomy, mechanical ventilation, ICU stay, brain injury