Estimation of the optimal time needed for weaning of Intensive Care Unit tracheostomized patients on mechanical ventilation. A prospective observational study.

BACKGROUND AND AIM: Determining the time that is required for weaning, as well as the factors that influence it can be used for the appropriate planning of patient's medical and nursing care. The aim of this study is to estimate the optimal time an Intensive Care Unit (ICU) patient with tracheostomy needs to wean from mechanical ventilation. METHODS: This prospective observational study was conducted on 162 patients from two general hospitals in Athens, Greece.  A specially designed recording form was created to conduct the study. The Statistical Package for the Social Sciences (SPSS) v.25 for Windows was used to record and analyze the data. The level of statistical significance was set at α=5%. RESULTS: Results were found after comparing and associating the demographic and clinical characteristics and medical history of patients with the duration of weaning, the length of post-tracheostomy ICU stay and the time from intubation to tracheostomy. CONCLUSIONS: According to the results of our study, there are various factors that affect success and duration of weaning. More specifically, there seems to be an association between duration of weaning and age, number of closure attempts, success of closure, time from intubation to tracheostomy, length of the patient's post-tracheostomy ICU stay and diagnosis upon admission. The shorter the duration of weaning, the greater the benefits for the patients themselves, such us avoiding respiratory damage, reduction of mortality and morbidity and preventing of length of patient's ICU stay.

Early versus Late Tracheostomy Promotes Weaning in Intensive Care Unit Patients: a retrospective observational study.

BACKGROUND AND AIM: The time interval between the patients' intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to ICU patients' weaning from respiratory support. METHODS: This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients' medical records in order to estimate the duration of patient weaning and the number of days from the patients' intubation until the time of tracheostomy. In the present study the term earlytracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomydefines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission. RESULTS: One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days. CONCLUSIONS: The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients' outcomes, and specifically ICU patients' weaning.