COMPARISON OF RESPIRATORY INFECTIONS BEFORE AND AFTER PERCUTANEOUS TRACHEOSTOMY

    Authors

    M. L. Sole; S. Talbert; D. A. Penoyer; M. Bennett; S. Sokol;J. Wilson

    Comments

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    Abbreviated Journal Title

    Am. J. Crit. Care

    Keywords

    VENTILATOR-ASSOCIATED PNEUMONIA; INTENSIVE-CARE-UNIT; PROLONGED; MECHANICAL VENTILATION; RESOURCE UTILIZATION; TRAUMA PATIENTS; OUTCOMES; METAANALYSIS; TRACHEOTOMY; PREVENTION; IMPACT; Critical Care Medicine; Nursing

    Abstract

    Background A tracheostomy is often performed when patients cannot be weaned from mechanical ventilation. Respiratory infections (ventilator-associated pneumonia and infection of the lower respiratory tract) complicate the course of hospitalization in patients receiving mechanical ventilation. Objectives To evaluate respiratory infections before and after a percutaneous tracheostomy and to describe their outcomes. Methods Medical records of adults who had percutaneous tracheostomy during a 1-year period at a tertiary care hospital in the southeastern United States were reviewed retrospectively. Results Data for 322 patients were analyzed. Patients were predominately male (63.0%) and white (57.8%), with a mean age of 57.4 years. Ventilator-associated pneumonia or infection of the lower respiratory tract was identified in 90 patients (28.0%); the majority of infections were lower respiratory infections. Of all infections, 52% occurred before the tracheostomy, and 48% occurred after the procedure. Respiratory infections were associated with longer stays and higher costs, which were significantly higher in patients in whom the infection developed after the tracheostomy. Gram-negative organisms were responsible for the majority of infections. Conclusions Data related to respiratory infections that occurred before a tracheostomy were similar to data related to infections that occurred after a tracheostomy. Most infections were classified as lower respiratory infection rather than pneumonia. Infection, before or after a tracheostomy, resulted in longer stays and higher costs for care. Interventions focused on preventing infection before and after tracheostomy are warranted.

    Journal Title

    American Journal of Critical Care

    Volume

    23

    Issue/Number

    6

    Publication Date

    1-1-2014

    Document Type

    Article

    Language

    English

    First Page

    E80

    Last Page

    E87

    WOS Identifier

    WOS:000347371300001

    ISSN

    1062-3264

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