Tracheostomy in the ICU: Hope or delusion?

Detalhes bibliográficos
Autor(a) principal: Antonio, Ana Carolina Peçanha
Data de Publicação: 2019
Outros Autores: Leivas, Ana Flávia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinical and Biomedical Research
Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/84734
Resumo: Introduction: Current literature suggests that tracheostomy has no impact on survival in unselected intensive care unit (ICU) patients, and that it actually transfers mortality from ICU to the ward. Methods: Data from 71 adult subjects who underwent tracheostomy as part of their ICU management and were subsequently transferred to the ward were obtained retrospectively. Results: During 2015, 104 subjects received tracheostomy. Thirty-two died during their initial ICU admission (30.4%) and were excluded from analysis. Of the remaining 73 individuals, 28 died (38.3%) in hospital. Most common diagnoses were sepsis (33.8%) and neurological emergencies (23.9%). Life-sustaining treatments were withheld or withdrawn in 25 decedents. Seven subjects died in later hospitalizations at our institution over the period recorded. Conclusions: Tracheostomy may represent a burden after ICU discharge, involving high resource use and low survival rate. Efforts should be made to recognize patients who might clearly benefit from this technique to avoid unwanted prolonged mechanical ventilation. Keywords: Tracheostomy; critical illness; decision-making
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spelling Tracheostomy in the ICU: Hope or delusion?Tracheostomycritical illnessdecision-makingIntroduction: Current literature suggests that tracheostomy has no impact on survival in unselected intensive care unit (ICU) patients, and that it actually transfers mortality from ICU to the ward. Methods: Data from 71 adult subjects who underwent tracheostomy as part of their ICU management and were subsequently transferred to the ward were obtained retrospectively. Results: During 2015, 104 subjects received tracheostomy. Thirty-two died during their initial ICU admission (30.4%) and were excluded from analysis. Of the remaining 73 individuals, 28 died (38.3%) in hospital. Most common diagnoses were sepsis (33.8%) and neurological emergencies (23.9%). Life-sustaining treatments were withheld or withdrawn in 25 decedents. Seven subjects died in later hospitalizations at our institution over the period recorded. Conclusions: Tracheostomy may represent a burden after ICU discharge, involving high resource use and low survival rate. Efforts should be made to recognize patients who might clearly benefit from this technique to avoid unwanted prolonged mechanical ventilation. Keywords: Tracheostomy; critical illness; decision-makingHCPA/FAMED/UFRGS2019-06-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed Articleapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/84734Clinical & Biomedical Research; Vol. 39 No. 1 (2019): Clinical and Biomedical ResearchClinical and Biomedical Research; v. 39 n. 1 (2019): Clinical and Biomedical Research2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSenghttps://seer.ufrgs.br/index.php/hcpa/article/view/84734/pdfCopyright (c) 2019 Clinical and Biomedical Researchinfo:eu-repo/semantics/openAccessAntonio, Ana Carolina PeçanhaLeivas, Ana Flávia2024-01-19T14:22:23Zoai:seer.ufrgs.br:article/84734Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2024-01-19T14:22:23Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.none.fl_str_mv Tracheostomy in the ICU: Hope or delusion?
title Tracheostomy in the ICU: Hope or delusion?
spellingShingle Tracheostomy in the ICU: Hope or delusion?
Antonio, Ana Carolina Peçanha
Tracheostomy
critical illness
decision-making
title_short Tracheostomy in the ICU: Hope or delusion?
title_full Tracheostomy in the ICU: Hope or delusion?
title_fullStr Tracheostomy in the ICU: Hope or delusion?
title_full_unstemmed Tracheostomy in the ICU: Hope or delusion?
title_sort Tracheostomy in the ICU: Hope or delusion?
author Antonio, Ana Carolina Peçanha
author_facet Antonio, Ana Carolina Peçanha
Leivas, Ana Flávia
author_role author
author2 Leivas, Ana Flávia
author2_role author
dc.contributor.author.fl_str_mv Antonio, Ana Carolina Peçanha
Leivas, Ana Flávia
dc.subject.por.fl_str_mv Tracheostomy
critical illness
decision-making
topic Tracheostomy
critical illness
decision-making
description Introduction: Current literature suggests that tracheostomy has no impact on survival in unselected intensive care unit (ICU) patients, and that it actually transfers mortality from ICU to the ward. Methods: Data from 71 adult subjects who underwent tracheostomy as part of their ICU management and were subsequently transferred to the ward were obtained retrospectively. Results: During 2015, 104 subjects received tracheostomy. Thirty-two died during their initial ICU admission (30.4%) and were excluded from analysis. Of the remaining 73 individuals, 28 died (38.3%) in hospital. Most common diagnoses were sepsis (33.8%) and neurological emergencies (23.9%). Life-sustaining treatments were withheld or withdrawn in 25 decedents. Seven subjects died in later hospitalizations at our institution over the period recorded. Conclusions: Tracheostomy may represent a burden after ICU discharge, involving high resource use and low survival rate. Efforts should be made to recognize patients who might clearly benefit from this technique to avoid unwanted prolonged mechanical ventilation. Keywords: Tracheostomy; critical illness; decision-making
publishDate 2019
dc.date.none.fl_str_mv 2019-06-28
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/84734
url https://seer.ufrgs.br/index.php/hcpa/article/view/84734
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/84734/pdf
dc.rights.driver.fl_str_mv Copyright (c) 2019 Clinical and Biomedical Research
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2019 Clinical and Biomedical Research
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv HCPA/FAMED/UFRGS
publisher.none.fl_str_mv HCPA/FAMED/UFRGS
dc.source.none.fl_str_mv Clinical & Biomedical Research; Vol. 39 No. 1 (2019): Clinical and Biomedical Research
Clinical and Biomedical Research; v. 39 n. 1 (2019): Clinical and Biomedical Research
2357-9730
reponame:Clinical and Biomedical Research
instname:Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
instname_str Universidade Federal do Rio Grande do Sul (UFRGS)
instacron_str UFRGS
institution UFRGS
reponame_str Clinical and Biomedical Research
collection Clinical and Biomedical Research
repository.name.fl_str_mv Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)
repository.mail.fl_str_mv ||cbr@hcpa.edu.br
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