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This retrospective study aims to study characteristics of patients tracheotomized in the Lausanne ICU, both overall and by primary reasons of intubation. Ventilation data both before and after tracheotomy, weaning technique and timing are studied in this retrospective study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intubation for respiratory reasons | All patients who were intubated for respiratory reasons (i.e. acute respiratory distress syndrome, pneumonias, pleural effusions for example) | ||
| Intubation for neurological reasons | All patients who were intubated for neurological reasons (i.e. stroke, intracranial bleeding, cervical fracture with tetraparesia for example) | ||
| Intubation for other reasons | All patients who were intubated for other reasons than respiratory or neurological (i.e. intubation before surgery, cardiac arrest, hemodynamic instability and polytraumatism without respiratory distress or neurological pathology necessitating intubation) |
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| Measure | Description | Time Frame |
|---|---|---|
| Time from intubation to tracheotomy | Calculated from clinical information system (time of intubation, time of tracheotomy), calculated in hours | Once, between time of intubation to time of tracheotomy, up to 60 days |
| Measure | Description | Time Frame |
|---|---|---|
| Age | Collected from electronic patient files. | At ICU admission |
| Weight | Collected from electronic patient files. | At ICU admission |
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Inclusion Criteria:
Exclusion Criteria:
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All patients admitted to the Lausanne ICU between May1st and November 31st who had a tracheotomy and were ventilated for more than 72 hours were screened for exclusion criterias. 147 patients were screened and 80 patients were included.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lausanne University Hospital | Lausanne | Canton of Vaud | 1011 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25581416 | Background | Andriolo BN, Andriolo RB, Saconato H, Atallah AN, Valente O. Early versus late tracheostomy for critically ill patients. Cochrane Database Syst Rev. 2015 Jan 12;1(1):CD007271. doi: 10.1002/14651858.CD007271.pub3. | |
| 15469579 | Background | Arabi Y, Haddad S, Shirawi N, Al Shimemeri A. Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review. Crit Care. 2004 Oct;8(5):R347-52. doi: 10.1186/cc2924. Epub 2004 Aug 23. |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| Height | Collected from electronic patient files. | At ICU admission |
| Body mass index | Calculated from weight and height | At ICU admission |
| Predicted body weight (PBW) | Calculated as such : Adult male: 50 + 0.91 (Height cm -152.4) / Adult female: 45 + 0.91 (Height cm -152.4) | At ICU admission |
| SOFA score (admission) | Calculated at admission | At ICU admission |
| Clinical Frailty Score | Calculated at ICU admission | At ICU admission |
| Charlson comorbidity index | Calculated at ICU admission | At ICU admission |
| Comorbidities | Collected at ICU admission | At ICU admission |
| Ventilation modalities and settings from intubation to tracheotomy | Ventilation modalities and settings recolted from electronic patient files. | Once every day at 8am, between day after intubation to day before tracheotomy, up to 60 days |
| Sedation opioid use from intubation to tracheotomy | Sedation use collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, between day of intubation to day of tracheotomy, up to 60 days |
| Opioid use from intubation to tracheotomy | Opioid use collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, between day of intubation to day of tracheotomy, up to 60 days |
| Neuromuscular blocking agent use from intubation to tracheotomy | Neuromuscular blocking agent use collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, between day of intubation to day of tracheotomy, up to 60 days |
| Tracheotomy time | Collected from electronic patient files (day and hour) | At time of tracheotomy, once, up to 60 days after intubation day |
| Tracheotomy type (percutaneous, surgical) | Collected from electronic patient files. | At time of tracheotomy, once, up to 60 days after intubation day |
| Ventilation settings and modalities from day of tracheotomy | Collected from electronic patient files. | 2 hours before tracheotomy |
| SOFA score (tracheotomy day) | Calculated from electronic patient files. | Once, on the day of tracheotomy (worst value of the day of tracheotomy), up to 60 days after intubation day |
| Ventilation modalities and settings from tracheotomy to mechanical ventilation weaning | Ventilation modalities and settings collected from electronic patient files. | Once per day, from day of tracheotomy to mechanical ventilation weaning, up to 60 days |
| Tracheotomy weaning strategies from tracheotomy to mechanical ventilation weaning | Data collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, from day of tracheotomy to day of mechanical ventilation weaning, up to 31 days |
| Physical therapy sessions from tracheotomy to mechanical ventilation weaning | Data collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, from day of tracheotomy to day of mechanical ventilation weaning, up to 31 days |
| Mechanical ventilation weaning day | Data collected from electronic patient files. | Once (day 3 in a row of less than 12 hours of mechanical ventilation), up to 31 days after tracheotomy day |
| SOFA score (mechanical ventilation weaning day) | Calcutated from electronic patient files. | Once (3rd consecutive day with less than 12-h of mechanical ventilation), up to 31 days after tracheotomy day |
| Ventilation modalities and settings from mechanical ventilation weaning day to decannulation or ICU discharge or death | Collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, from day of mechanical ventilation weaning to decannulation or ICU discharge or death, up to 31 days |
| Physical therapy sessions from mechanical ventilation weaning day to decannulation or ICU discharge or death | Collected from electronic patient files. | Once every day at 8am and at time of minimal and maximal value, from day of mechanical ventilation weaning to decannulation or ICU discharge or death, up to 31 days |
| Hospital stay duration | Collected from electronic patient files and discharge letters | Once, between day of hospital admission to day of hospital discharge, up to 2 years |
| Outcome and specific treatments in ICU | Data recolted from electronic patient files | Once, between day of hospital admission to day of hospital discharge, up to 2 years |
| Correlation of ventilation settings and modalities and tracheotomy weaning strategies | Collected from electronic patient files and discharge letters | Once, between day of hospital admission to day of hospital discharge, up to 2 years |
| 27626706 | Background | Beduneau G, Pham T, Schortgen F, Piquilloud L, Zogheib E, Jonas M, Grelon F, Runge I, Nicolas Terzi, Grange S, Barberet G, Guitard PG, Frat JP, Constan A, Chretien JM, Mancebo J, Mercat A, Richard JM, Brochard L; WIND (Weaning according to a New Definition) Study Group and the REVA (Reseau Europeen de Recherche en Ventilation Artificielle) Network double dagger. Epidemiology of Weaning Outcome according to a New Definition. The WIND Study. Am J Respir Crit Care Med. 2017 Mar 15;195(6):772-783. doi: 10.1164/rccm.201602-0320OC. |
| 28576127 | Background | Burns KEA, Soliman I, Adhikari NKJ, Zwein A, Wong JTY, Gomez-Builes C, Pellegrini JA, Chen L, Rittayamai N, Sklar M, Brochard LJ, Friedrich JO. Trials directly comparing alternative spontaneous breathing trial techniques: a systematic review and meta-analysis. Crit Care. 2017 Jun 1;21(1):127. doi: 10.1186/s13054-017-1698-x. |
| 16606435 | Background | Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care. 2006;10(2):R55. doi: 10.1186/cc4887. |
| 27601069 | Background | McCredie VA, Alali AS, Scales DC, Adhikari NK, Rubenfeld GD, Cuthbertson BH, Nathens AB. Effect of Early Versus Late Tracheostomy or Prolonged Intubation in Critically Ill Patients with Acute Brain Injury: A Systematic Review and Meta-Analysis. Neurocrit Care. 2017 Feb;26(1):14-25. doi: 10.1007/s12028-016-0297-z. |
| 31397716 | Background | Mehta AB, Walkey AJ, Curran-Everett D, Douglas IS. One-Year Outcomes Following Tracheostomy for Acute Respiratory Failure. Crit Care Med. 2019 Nov;47(11):1572-1581. doi: 10.1097/CCM.0000000000003959. |
| 23695482 | Background | Young D, Harrison DA, Cuthbertson BH, Rowan K; TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA. 2013 May 22;309(20):2121-9. doi: 10.1001/jama.2013.5154. |