"Outcomes of Tracheostomy Done for Patients Admitted in Anesthesia Intensive Care Units of Assiut University Hospital"
Condition: Tracheostomy Complication
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      This study was undertaken to Identify the factors affecting the outcomes of tracheostomy done
      in ICU for patients subjected to prolonged intubation and ventilation and to suggest
      guidelines to control:

        1. proper timing of tracheostomy

        2. process of decannulation.
    

Detailed description: 
      Tracheostomy is described as the creation of a stoma at the skin surface which leads into the
      trachea. From the first tracheostomy until about 1930, the operation was performed
      exclusively for laryngeal obstruction. Nowadays, due to the development of the care of
      critically ill patients in intensive care units (ICUs), there are other indications for the
      procedure including prolonged intubation and pulmonary toilet.

      The initial management of patients in an intensive care unit involves a series of
      interventions that aim to stabilize and then optimize their physiological state. Mechanical
      ventilation (MV) is a commonly utilized intervention to support a patient's respiratory
      function. The second phase in ICU management focuses on weaning the patient from the
      artificial supportive mechanisms.

      The principle role of tracheostomy in the ICU is to expedite the weaning process in patients
      requiring prolonged mechanical ventilation and those predicted to be at risk of pulmonary
      aspiration. Tracheostomy facilitates weaning primarily by allowing increased level of patient
      activity and mobility.

      Tracheostomy protects the larynx and the upper airway from prolonged intubation which may
      lead to laryngotracheal stenosis. Patients with tracheostomies tend to have fewer days of
      mechanical ventilation because of the improvements in the respiratory physiology. This is
      especially in trauma patients. They have improved secretion clearance as suction is easy and
      less strength is required for expectoration. This may be linked to the lower incidence of
      pneumonia and respiratory infections seen, especially in trauma victims.

      Patients with tracheostomy are less sedated and therefore able to move in bed. The patients
      may also be able to swallow, so may be started on oral feeding sooner and mouth care is
      easier compared with an endotracheal tube (ETT) tube.
    

Intervention name(s): Tracheostomy tube
Intervention type(s): Device
Intervention description(s): Tracheostomy done to all patients by open surgical technique and was done in ICUs without need to transfer to theatre.
Other intervention name(s): TT
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Tracheostomy done to all patients by open surgical technique and was done in ICUs without need to transfer to theatre. The patients were followed up daily until discharge from ICU. The following items were recorded: Duration of application of tracheostomy tube before decannulation (cannulation time), complications of tracheostomy, mortality due to tracheostomy.
Masking: None (Open Label)
Primary purpose: Treatment