Role of tracheotomy in ventilator Article Example | Topics and Well Written Essays - 2000 words

Role of tracheotomy in ventilator - Article ExampleTracheotomy is usually performed for critically ill, ventilator-dependent patients to provide long-term airway access. The benefits commonly ascribed to tracheotomy, compared to prolonged translaryngeal intubation, include improved patient comfort, more effective airway suctioning, decreased airway resistance, intensify patient mobility, increased opportunities for articu tardilyd speech, ability to prey orally, and a more secure airway. Conceptually, these advantages might government issue in hardly a(prenominal)er ventilator complications (eg, ventilator-associated pneumonia), accelerated ablactate from mechanical ventilation, and the ability to transfer ventilator-dependent patients from the ICU. Concern, however, exists about the risks associated with the surgical procedure and the costs involved. The impact of tracheotomy on the distance of mechanical ventilation and on ICU outcomes in general has been examined by severa l different force field designs, none of them ideal. Most studies are retrospective, although a few prospective studies have been performed. A serious job is that many studies assigned patients to treatment groups on the initiation of physician practice patterns rather than random assignment. Those studies that use random assignment frequently used quasi-randomization methods (eg, each other patient, every other day, hospital eternalize number, or odd-even days). Studies have compared patients undergoing tracheotomy vs those not undergoing tracheotomy, and patients undergoing first tracheotomy vs those undergoing of late tracheotomy.... decreased airway resistance, enhanced patient mobility,increased opportunities for articulated speech, abilityto eat orally, and a more secure airway. Conceptually,these advantages might result in fewer ventilator complications(eg, ventilator-associated pneumonia), acceleratedweaning from mechanical ventilation, and the ability totransfer vent ilator-dependent patients from the ICU. Concern,however, exists about the risks associated with theprocedure and the costs involved.The impact of tracheotomy on the duration of mechanicalventilation and on ICU outcomes in general has beenexamined by several different study designs, none of themideal. Most studies are retrospective, although a fewprospective studies have been performed. A serious problemis that many studies assigned patients to treatmentgroups on the basis of physician practice patterns ratherthan random assignment. Those studies that used randomassignment frequently used quasi-randomization methods(eg, every other patient, every other day, hospital recordnumber, or odd-even days). Studies have compared patientsundergoing tracheotomy vs those not undergoingtracheotomy, and patients undergoing early tracheotomyvs those undergoing late tracheotomy. The definition ofearly vs late tracheotomy varies between studies. Earlymay be defined as a period as short as 2 days afte r the startof mechanical ventilation to as late as 10 days after thestart.Patient populations included in studies also vary astraybetween investigations and include general surgical andmedical patients in some studies and specific patientgroups (eg, combat injury patients or head-injured patients) inother studies. Most studies have design flaws in thecollection and analysis of data, initiatory of which