ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Does early tracheostomy decrease the nosocomial pneumonia incidence in cardiovascular surgery patients?
Sema Turan, Soner Yavaş, İhsan Ayık, Bülent Yamak, Elif Dilber, Özcan Erdemli
Department of Anesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2012.048
Background: This study aims to examine the correlation between the incidence of nosocomial pneumonia and the timing of tracheostomy in our cardiovascular intensive care unit (ICU).

Methods: Between January 2008 and December 2009, 64 patients who were monitored in the cardiovascular surgery ICU and underwent tracheostomy were included in this retrospective study. The patients were divided into four groups according to their clinical pulmonary infection scores (CPIS) and the timing of tracheostomy. Group 1E (n=11): Patients with CPIS ≤5 who underwent tracheostomy within seven days of endotracheal intubation. Group 1L (n=9): Patients with CPIS ≤5 who underwent tracheostomy after seven days from endotracheal intubation. Group 2E (n=13): Patients with CPIS ≥6 who underwent tracheostomy within seven days of endotracheal intubation. Group 2L (n=31): Patients with CPIS ≥6 who underwent tracheostomy after seven days from endotracheal intubation.

Results: Comparison of the incidence of nosocomial pneumonia of the patients following tracheostomy showed no statistically significant difference between group 1E and 1L. Also, there was no significant difference between group 2E and 2L in terms of superinfection rates of the patients following tracheostomy. However, a significant difference was observed between group 1E (24.9±4.3) and group 1L (30.4±4.4) (p=0.012) in terms of APACHE II scores. Significantly lower mortality rates were observed in group 1E, compared to group 1L (p=0.043), but not between group 2E and 2L.

Conclusion: We concluded that early tracheostomy does not decrease the incidence of nosocomial pneumonia and superinfection following tracheostomy.

Keywords : Early versus late tracheostomy; intensive care unit; pneumonia
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