The influence of early tracheostomy in the weaning of patients with severe traumatic brain injury

BACKGROUND AND OBJECTIVES: Actually, It’s doubtful if early tracheostomy (ET) can influence mechanical ventilation (MV) weaning time or the hospital length of stay in patients with traumatic brain injury (TBI). The main objective of this trial was to verify the influence of ET on weaning time of patients with severe TBI. METHODS: Prospective, observational study, including 33 patients with severe TBI (GCS < 10 at hospital admission), evaluated according to tracheostomy performance time (early: t < 6 days; intermediate: t = 7 to 11 days; and late: t > 12 days) and the weaning from MV. RESULTS: Total ventilation mechanical time has been reduced in the early tracheostomy group (n = 10; p < 0.0001). A lower GCS punctuation (mean 5.3 ± 2.5) in ET group has been negatively correlated with hospital length of stay (LOS) (p = 0.02). CONCLUSIONS: Early tracheostomy can decrease mechanical ventilation time, but does not influence hospital LOS in patients with severe traumatic brain injury.

mechanical ventilation; tracheostomy; traumatic brain injury; weaning

Associação de Medicina Intensiva Brasileira - AMIB Rua Arminda, 93 - Vila Olímpia, CEP 04545-100 - São Paulo - SP - Brasil, Tel.: (11) 5089-2642 - São Paulo - SP - Brazil