TITLE:
Early versus Late Tracheostomy for Ventilator Dependence after Cardiovascular Surgery: Long-Term Results
AUTHORS:
Joseph M. Ladowski, Hannah E. Downey, Bennet J. Ladowski, Joseph S. Ladowski
KEYWORDS:
Surgery Cardiovascular; Injury Lung; Intensive Care; Mediastinitis
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.3 No.3,
July
16,
2013
ABSTRACT: Although concerns exist about the possibility of infecting a sternotomy wound by performing a tracheostomy early after cardiac surgery, it has been shown that tracheostomy performed before postoperative day 10 can improve outcomes for cardiovascular surgery patients who require long-term ventilation. We retrospectively reviewed all charts for patients who underwent cardiovascular surgery and required tracheostomy at a single-institution site from January 2005 to July 2012. Patients were divided into two groups based upon whether their tracheostomy was performed less than 10 days after their initial operation (early tracheostomy) or ≥10 days after their initial operation (late tracheostomy). Preoperative demographics and postoperative complications were studied. There were no new mediastinitis episodes following tracheostomy. Early tracheostomy was associated with higher 90-day (74.4% vs 56.8%) and 180-day (47.4% vs 28.7%, p 0.047) survival when compared to late tracheostomy. Early tracheostomy after cardiovascular surgery does not seem to be associated with an increased rate of mediastinitis but is associated with improved survival.