Abstract
Background
The optimal timing of tracheotomy in critically ill ventilated patients remains controversial.
Objectives
The objective of this meta-analysis was to assess tracheotomy timing for critically
ill ventilated patients and determine the outcomes’ reliability.
Methods
We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials.
Results
Compared with late tracheotomy, early tracheotomy presented a lower incidence of ventilator-associated
pneumonia (VAP), shorter duration of mechanical ventilation (MV), and shorter intensive
care unit (ICU) stay. However, trial sequential analysis (TSA), a kind of cumulative
meta-analysis, indicated that the evidence was unreliable and inconclusive.
Conclusions
The Findings suggest that early tracheotomy seems to be associated with a lower incidence
of VAP, shorter duration of MV, shorter duration of sedation, and shorter ICU stay.
However, the apparent benefits revealed in traditional meta-analysis contrast with
the post-TSA results. More fully powered, randomized controlled trials focused on
the outcomes of tracheotomy are highly warranted.
Keywords
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Article info
Publication history
Published online: October 15, 2018
Accepted:
September 11,
2018
Received in revised form:
September 7,
2018
Received:
April 20,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
