Does early tracheostomy affect the duration of mechanical ventilation in patients with severe traumatic head injuries?

Abstract Background and purpose Tracheostomy is a surgical procedure performed frequently in intensive care units (ICUs). Prolonged mechanical ventilation (MV) is the main indication for tracheostomy in ICUs. This study was conducted to investigate if early tracheostomy affects the duration of mechanical ventilation in patients with severe traumatic head injuries. Patients and Methods It is a prospective, randomized study in which patients with severe post-traumatic head injuries, with a Glasgow Coma Scale of less than 8, were included. Patients were randomized into two groups; group of early tracheostomy (ET) included 53 patients subjected to tracheostomy before the seventh day of intubation and group of late tracheostomy (LT) included 34 patients subjected to tracheostomy on or after the seventh day of intubation. The total duration of mechanical ventilation, the complications of tracheostomy, and mortality were recorded. Results The mean duration of mechanical ventilation of ET group (ET=10.97±6.82) was statistically significantly shorter than the LT group (LT=16.28±8.65) (P=0.002). Complications were minor and not life threating. No mortalities were detected because of tracheostomy. Conclusion Tracheostomy is a safe procedure with acceptable rate of minor complications. Early tracheostomy, before the seventh day of intubation, significantly shortens the duration of mechanical ventilation in patients with severe traumatic head injuries