Title

Comparison Of Respiratory Infections Before And After Percutaneous Tracheostomy

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 tra -cheostomy 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 pneu -monia. 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.

Publication Date

1-1-2014

Publication Title

American Journal of Critical Care

Volume

23

Issue

6

Number of Pages

e80-e87

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.4037/ajcc2014232

Socpus ID

84920117321 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84920117321

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