Tracheostomy as a component of intensive care for central nervous system diseases
https://doi.org/10.51523/2708-6011.2022-19-4-05
Abstract
Objective. To reveal the effective and safe timing of tracheostomy in patients with CNS diseases by comparative assessment of the duration of respiratory support and ICU, the frequency of development ventilator-associated pneumonia, the assessment of the level of consciousness according to the Glasgow Coma Scale (GCS), survival rate, as well as the incidence of complications rate.
Materials and methods. A retrospective study was conducted among neurological and neurosurgical patients treated from 2010 to 2017 who underwent tracheostomy. Patients (n=131) were divided into 3 groups depending on the tracheostomy time.
Results. The relation between early tracheostomy and the duration of respiratory support, the ICU bed-day, the probability of developing ventilator-associated pneumonia in patients with the central nervous system pathology was revealed; no relationship was found between the tracheostomy time and the neurological outcome and survival rate in this category patients.
Conclusion. The use of early tracheostomy in intensive care of patients with the central nervous system pathology is effective, which is proved by a 2,2 times reduction of the duration of mechanical ventilation, by a 1.9 times reduction of the duration of the ICU day, by a 1.6 times lower risk of developing ventilator-associated pneumonia, without affecting outcomes and being safe due to the absence a lot of complications both during and after the surgical intervention.
About the Authors
A. M. Karamyshau
Gomel State Medical University
Belarus
Belarus
Andrei M. Karamyshau, Candidate of Medical Sciences,
Associate Professor at the Department of Anesthesiology and Intensive Care
Gomel
A. V. Leonau
Gomel Regional Clinical Oncological Dispensary
Belarus
Belarus
Andrei V. Leonau, Doctor of the Department of
Anesthesiology and Intensive Care
Gomel
P. A. Shcharbakova
Gomel Clinical City
Hospital №3
Belarus
Belarus
Palina A. Shcharbakova, Doctor of the Department of
Anesthesiology and Intensive Care
Gomel
A. L. Hrybach
Gomel Regional Children Clinical Hospital
Belarus
Belarus
Aliaksei L. Hrybach, Head of the Operating Theater
Gomel
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Review
For citations:
Karamyshau A.M., Leonau A.V., Shcharbakova P.A., Hrybach A.L. Tracheostomy as a component of intensive care for central nervous system diseases. Health and Ecology Issues. 2022;19(4):35-41. (In Russ.) https://doi.org/10.51523/2708-6011.2022-19-4-05
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