The impact of early percutaneous tracheotomy on reduction of the incidence of ventilator associated pneumonia and the course and outcome of ICU patients

Sa？etak Te aim of the study. Te primary objective of this study was to determine the diferences in the incidence of respiratory infections and septic episodes in patients who underwent early percutaneous tracheotomy (ET) and in patients who underwent translaryngeal intubation i.e late tracheotomy (LT). Secondary objectives were to determine the diferences in the early mortality of patients, duration of mechanical ventilation and length of Intensive care unit (ICU) stay. Materials and methods. Te study included 72 surgical and trauma patients older than 18 years of age, treated at the ICU of the University Clinical Hospital Mostar who had undergone translaryngeal intubation and were mechanically ventilated for at least 48 hours. Te basic criterion for inclusion in the study was expected duration of mechanical ventilation of at least 14 days. Forty-eight hours afer enrollment, patients were randomly divided into two groups. Te frst group of patients underwent ET afer 2-4 days of mechanical ventilation; the second group underwent LT if they exhibited longer episodes of hypoxemia afer 15 days. Results. Te ET group of patients spent less time in mechanical ventilation and ICU. Te ET group had a lower rate of VAS pneumonia (p=0.137), sepsis episodes (p=0.029) and mortality rate (p=0.056). Conclusion. Te results of our study support ET being performed 2–4 days from the start of mechanical ventilation. Despite a lack of power, we found signifcant benefts of ET regarding the incidence of pneumonia, sepsis, hospital mortality, duration of mechanical ventilation and length of ICU stay