COMPARISON OF RESPIRATORY INFECTIONS BEFORE AND AFTER PERCUTANEOUS TRACHEOSTOMY
Abbreviated Journal Title
Am. J. Crit. Care
VENTILATOR-ASSOCIATED PNEUMONIA; INTENSIVE-CARE-UNIT; PROLONGED; MECHANICAL VENTILATION; RESOURCE UTILIZATION; TRAUMA PATIENTS; OUTCOMES; METAANALYSIS; TRACHEOTOMY; PREVENTION; IMPACT; Critical Care Medicine; Nursing
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.
American Journal of Critical Care
"COMPARISON OF RESPIRATORY INFECTIONS BEFORE AND AFTER PERCUTANEOUS TRACHEOSTOMY" (2014). Faculty Bibliography 2010s. 6107.