Tracheostomy timing and the duration of weaning in patients with acute respiratory failure 英文参考文献.docVIP

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Tracheostomy timing and the duration of weaning in patients with acute respiratory failure 英文参考文献.doc

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Tracheostomy timing and the duration of weaning in patients with acute respiratory failure 英文参考文献

Available online /content/8/4/R261 Research Open Access August 2004 Vol 8 No 4 Tracheostomy timing and the duration of weaning in patients with acute respiratory failure Jackie H Boynton1, Kenneth Hawkins1, Brian J Eastridge2 and Grant E OKeefe3 1Department of Respiratory Care, Parkland Health and Hospital Systems, Dallas, Texas, USA 2Department of Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA 3Department of Surgery, University of Washington, Harborview Medical Center, Seattle, Washington, USA Corresponding author: Grant E OKeefe, gokeefe@ Received: 13 February 2004 Revisions requested: 25 March 2004 Revisions received: 29 April 2004 Accepted: 13 May 2004 Critical Care 2004, 8:R261-R267 (DOI 10.1186/cc2885) This article is online at: /content/8/4/R261 ? 2004 Boynton et al.; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the articles original URL. Published: 24 June 2004 Abstract Introduction The effect of various airway management strategies, such as the timing of tracheostomy, on liberation from mechanical ventilation (MV) is uncertain. We tested the hypothesis that tracheostomy, when performed prior to active weaning, does not influence the duration of weaning or of MV in comparison with a more selective use of tracheostomy. Patients and methods In this observational prospective cohort study, surgical patients requiring ≥ 72 hours of MV were followed prospectively. Patients undergoing tracheostomy prior to any active weaning attempts (early tracheostomy [ET]) were compared with patients in whom initial weaning attempts were made with the endotracheal tube in place (selective tracheostomy [ST]). Results We compared the duration of weaning, the total duration of MV and the frequency of fatigue and pneumonia. Seventy-four patients