Tracheostomy in TBI Patients: Surgical vs. Percutaneous Timing Effects
Journal name: The Malaysian Journal of Medical Sciences
Original article title: The Practice, Outcome and Complications of Tracheostomy in Traumatic Brain Injury Patients in a Neurosurgical Intensive Care Unit: Surgical versus Percutaneous Tracheostomy and Early versus Late Tracheostomy
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
This page presents a generated summary with additional references; See source (below) for actual content.
Original source:
This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.
Yusrina Zahari, Wan Mohd Nazaruddin Wan Hassan, Mohd Hasyizan Hassan, Rhendra Hardy Mohamad Zaini, Baharuddin Abdullah
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: The Practice, Outcome and Complications of Tracheostomy in Traumatic Brain Injury Patients in a Neurosurgical Intensive Care Unit: Surgical versus Percutaneous Tracheostomy and Early versus Late Tracheostomy
Year: 2022 | Doi: 10.21315/mjms2022.29.3.7
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Traumatic brain injury (TBI) is one of the leading causes for intensive care unit admissions, particularly in Malaysia, where a significant percentage of trauma cases stem from incidents such as motor vehicle accidents and falls. Patients with severe TBI often require interventions like tracheostomy to facilitate the weaning off mechanical ventilation and to reduce the risk of ventilator-associated pneumonia. Tracheostomy can be performed using various techniques, notably surgical tracheostomy (ST) and percutaneous tracheostomy (PT). This study evaluates the outcomes of these two techniques and the impact of timing—early versus late tracheostomy—on patient recovery and hospital stays.
Importance of Tracheostomy Timing and Technique
The study highlights that early tracheostomy (ET) leads to shorter durations of mechanical ventilation and intensive care unit stays compared to late tracheostomy (LT). Specifically, ET improved patient outcomes significantly, resulting in decreased mechanical ventilation duration (8.8 versus 12.9 days), ICU stays (11.4 versus 15.2 days), and overall hospital stays (17.1 versus 20.0 days). Moreover, PT was performed quicker than ST, indicating a faster execution of tracheostomy plans and leading to fewer days of mechanical ventilation and ICU stay. Despite these benefits, it was noted that LT patients had better GCS scores upon discharge, suggesting a nuanced relationship between the timing of the procedure and recovery outcomes.
Conclusion
The findings from the study underscore the effectiveness of early percutaneous tracheostomy in improving recovery metrics for TBI patients compared to surgical techniques and late interventions. While PT showed a significant advantage in the duration of mechanical ventilation and ICU stay, the study also emphasizes the potential for late tracheostomy to produce favorable discharge outcomes in certain cases. The variability in outcomes highlights the need for a tailored approach to tracheostomy, correlating technique and timing with patient-specific needs. Future research, especially prospective randomized controlled trials, could further clarify the best practices in tracheostomy techniques for improving patient recovery in TBI cases.
FAQ section (important questions/answers):
What is the purpose of the study on tracheostomy?
The study aimed to evaluate the practice, outcomes, and complications of surgical tracheostomy versus percutaneous tracheostomy, and early tracheostomy versus late tracheostomy in patients with severe traumatic brain injury.
What were the primary findings regarding percutaneous tracheostomy?
Percutaneous tracheostomy demonstrated shorter durations for the day of tracheostomy decision, execution, mechanical ventilation, and ICU stay compared to surgical tracheostomy, indicating better efficiency and outcomes for patients.
How did early and late tracheostomy affect patient outcomes?
Early tracheostomy resulted in significantly shorter durations of mechanical ventilation, ICU stay, and hospital stay, while late tracheostomy showed better GCS scores at discharge and GOS scores at six months.
Were there any significant complications noted in tracheostomy techniques?
The study found no significant complications between percutaneous and surgical tracheostomy techniques, suggesting both methods are safe when performed correctly.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Tracheostomy in TBI Patients: Surgical vs. Percutaneous Timing Effects”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Table:
In medical research, a 'Table' presents organized data to facilitate comparison and analysis. Tables compile results of experiments or observations, making complex information easily digestible. They help in visually summarizing findings, such as demographic details or outcome measures, allowing researchers to quickly draw conclusions and convey key results succinctly.
2) Study (Studying):
A 'Study' refers to a systematic investigation designed to answer specific research questions. In medical contexts, studies assess the efficacy of treatments or interventions, evaluate patient outcomes, or explore the relationship between variables, such as demographics and health conditions. Understanding the study design is crucial for interpreting research findings accurately and effectively.
3) Rules:
In the context of medical research, 'Rules' often refer to guidelines or protocols that dictate how a study is conducted, including inclusion and exclusion criteria for participants, ethical considerations, and methods. Adhering to established rules ensures the reliability and validity of the study’s results, enhancing the credibility of its findings.
4) Bleeding:
'Bleeding' signifies the loss of blood, which can pose serious health risks, particularly in traumatic brain injury cases. In surgical procedures like tracheostomy, understanding potential bleeding complications is crucial for surgical planning. Monitoring and managing bleeding effectively can significantly influence patient outcomes and recovery trajectories following surgery.
5) Relative:
The term 'Relative' in medical studies often pertains to how certain measurements compare or relate to others, such as changes in patient conditions relative to treatment variables. Understanding relative effects or risks can provide insights into the effectiveness or safety of interventions, guiding clinical decisions and patient management strategies accordingly.
6) Male:
'Male' denotes a gender category often highlighted in medical studies for demographic analysis. It is important to examine any gender differences in health outcomes, disease prevalence, or treatment responses. Data concerning male patients can inform clinicians about potential gender-specific needs and considerations in treatment protocols or health services.
7) Developing:
'Developing' in healthcare contexts usually refers to emerging or low-resource countries or regions where medical infrastructure, economic stability, and healthcare access are less established. Understanding healthcare issues within developing regions is vital for addressing health disparities, implementing effective interventions, and shaping the direction of global health policies.
8) Adhikarin (Adhikari):
The term 'Adhikari' likely refers to a specific author or researcher in the field of medical studies. Recognizing contributions from various researchers, such as Adhikari, is important for acknowledging their role in advancing knowledge, conducting transformative research, and influencing clinical practices through evidenced-based findings in traumatic brain injury management.
9) Reason:
'Reason' signifies the justifications or motivations behind certain clinical practices or research paths. In the context of medical studies, understanding the reason for specific decisions can shed light on their significance, enabling stakeholders to better appreciate underlying rationales that guide patient care, treatment protocols, and future research initiatives.
10) Indian:
'Indian' may pertain to research conducted within India or focus on its population in medical studies. Recognizing regional demographics and health concerns is essential for tailoring healthcare interventions and understanding cultural factors that may affect treatment adherence, healthcare access, and outcomes in India's diverse population.
11) Varga:
'Varga' could be a reference to an author or researcher associated with studies in medical literature. Acknowledging contributions from researchers like Varga is fundamental in understanding the evolution of medical knowledge and practice, especially in areas such as trauma care and surgical interventions, resulting from their published findings.
12) Burning (Burn, Burned, Burnt):
'Burn' often refers to physical injuries resulting from thermal, electrical, or chemical damage to tissues. In medical research, particularly in trauma cases, studying the management and treatment of burn injuries is crucial, given their complexity and the need for specialized care, influencing patient recovery and rehabilitation outcomes dramatically.
13) Calculation:
In medical research, 'Calculation' pertains to quantitative analysis methods used to derive meaningful insights from data. These calculations can include statistical measures, sample size estimations, or outcome assessments, which are essential for validating hypotheses, determining treatment efficacy, and guiding clinical practices based on empirical evidence.
14) Discussion:
'Discussion' in research manuscripts offers a comprehensive analysis of study findings. It interprets results, addresses limitations, proposes implications for clinical practice, and suggests future research directions. The discussion section is critical for contextualizing results within existing literature, enabling researchers to contribute more effectively to the larger medical dialogue.
15) Evolution:
'Evolution' in a medical context can refer to the progression or improvement of clinical practices, treatments, techniques, or understanding of diseases over time. Recognizing how medical practices evolve helps professionals adapt evidence-based approaches to patient care, leading to enhanced health outcomes and improved patient management strategies.
16) Training:
In healthcare, 'Training' refers to the educational pathways and competencies required for medical professionals to perform specific procedures or manage patient care effectively. Ensuring thorough training is vital for achieving optimal outcomes, especially in procedures like tracheostomy, where both skill and knowledge greatly impact patient safety and recovery rates.
17) Nature:
In medical research, 'Nature' can signify the inherent characteristics or conditions of subjects under study, such as the nature of injuries in traumatic brain injury cases. Understanding the nature of a condition informs treatment strategies, guiding clinicians in tailoring interventions to the specific needs and circumstances of patients.
18) Mamo:
'Mamo' may refer to a researcher or clinical expert contributing to relevant studies in the medical field. Acknowledging the work of professionals like Mamo can highlight important clinical insights or discoveries, helping to advance medical knowledge in specific areas, such as the management of traumatic brain injuries.
19) Hand:
'Hand' in surgical contexts often refers to the surgeon's operative area or techniques. Understanding hand skills and dexterity is critical in procedures like tracheostomy, where precision can significantly impact patient outcomes. Professionals develop these skills through training, experience, and familiarity with surgical procedures.
20) Gold (Golden):
'Gold' represents the standard of excellence in medical interventions or surgical techniques. For instance, a 'gold standard' is a benchmark against which other treatments are measured. Understanding what constitutes gold-level care helps healthcare providers aim for optimal practices and high-quality outcomes for patients.
21) Post:
'Post' indicates a period after an event, such as post-surgery or post-operative recovery. In medical studies, post-event analysis is critical for evaluating surgical outcomes, complications, and recovery processes, providing insights into patient progress and informing future care pathways or interventions based on observed results.
22) Coma:
A 'Coma' is a state of prolonged unconsciousness where a patient does not respond to environmental stimuli. In severe traumatic brain injury cases, understanding the implications of coma is crucial, as it influences treatment decisions, prognostication, and the overall management of patients' rehabilitation and long-term care needs.
23) Pur:
The term 'Poor' often describes suboptimal health conditions, outcomes, or prognoses in medical contexts. Identifying patients with poor recovery or health can help guide healthcare providers in tailoring interventions, allocating resources effectively, and implementing supportive measures necessary to improve patient care and outcomes.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Tracheostomy in TBI Patients: Surgical vs. Percutaneous Timing Effects’. Further sources in the context of Science might help you critically compare this page with similair documents:
Icu, Obstruction, Causal relationship, Surgical intervention, Previous history, Conflict of interest, Significant difference, Clinical studies, Clinical Practice, Systematic Review, Mortality Rate, Retrospective study, Surgical Procedure, Statistically significant difference, Significant association, Intensive care unit, Delayed complication, Hospital stay, Long term complication, Glasgow Coma Scale, Surgical technique, Traumatic injuries, Outcome Parameters, Longitudinal follow-up, Clinical outcome, Major bleeding, Ventilator-associated pneumonia, Traumatic brain injury, Patient Outcome, Hospital Budget, Subarachnoid haemorrhage, GC, Mechanical ventilation, Hospital stay duration, No significant association, Duration of mechanical ventilation, Randomised controlled trial, Patient comfort, Surgical bleeding, Tracheostomy procedure, Tracheostomy care, Tracheostomy complications, Hospital Mortality, Neurosurgeon, Surgical Team, Tracheostomy, Numerical data, Intervention details, Scarring, Categorical data, Clinical expertise, Motor vehicle accident, Authors contribution, Medical record.