Tracheostomy on the intensive care unit - a two-month network-wide snapshot

Abstract

Tracheostomy is a common and invasive procedure performed on the intensive care unit and has significant associated complications. Current evidence is insufficient to clearly guide practice. We conducted a two-month prospective service evaluation of tracheostomy within our local critical care network. We found 80 tracheostomies were performed during this time. Tracheostomy was performed at a median of six days after commencement of invasive ventilation, most commonly using the Ciaglia technique. Eighteen tracheostomies (23%) were performed surgically. The facilitation of weaning from invasive ventilation was the most common indication for tracheostomy. The median (IQR) time from tracheostomy to completion of weaning from mechanical ventilation was seven (4-11) days and from tracheostomy to decannulation was 14 (9-26) days. Eleven patients (14%) sustained complications possibly relating to tracheostomy insertion, three of whom subsequently died, although tracheostomy insertion was only possibly linked to one of these deaths. While our sample is small, it benchmarks a UK critical care network's tracheostomy practice in the UK.