Early versus late tracheostomy for traumatic brain injury: a systematic review and meta-analysis
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Le résumé fourni par la source
INTRODUCTION: Tracheostomy is the most frequent bedside surgical procedure performed on patients with traumatic brain injury who require mechanical ventilation. To compare the effects of early tracheostomy vs. late tracheostomy on the duration of mechanical ventilation in patients with traumatic brain injury, we carried out a systematic review and meta-analysis. EVIDENCE ACQUISITION: October 2022. Eligible clinical trials and observational studies reporting early versus late tracheostomy in TBI were searched. Two reviewers extracted data and independently assessed the risk of bias. The duration of mechanical ventilation was the primary outcome. EVIDENCE SYNTHESIS: We pooled standardized mean differences and risk differences for random effects model. A total of 368 studies were retrieved and screened. Nineteen studies were selected, including 6253 patients. Mean time for early tracheostomy and late tracheostomy procedures was 6±2.9 days and 17±10.7 days, respectively. Early tracheostomy was associated with shorter mechanical ventilation duration (SMD=-1.79, 95% CI -2.71; -0.88) and fewer ventilator associated pneumonia (RD=-0.11, 95% CI -0.16; -0.06) when compared with late tracheostomy. Moreover, intensive care unit (ICU) (SMD=-1.64, 95% CI -2.44; -0.84) and hospital (SMD=-1.26, 95% CI -1.97; -0.56) length of stay were shorter when compared with late tracheostomy. CONCLUSIONS: The findings from this meta-analysis suggest that early tracheostomy in severe TBI patients contributes to a lower exposure to secondary insults and nosocomial adverse events, increasing the opportunity of patient's early rehabilitation and discharge.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Early versus late tracheostomy for traumatic brain injury: a systematic review and meta-analysis
- Date Crossref
- 01/05/2023
- Éditeur
- Edizioni Minerva Medica
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Azienda Ospedaliera Universitaria Pisana pays non établi dans la noticeÉtablissement de santé
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University of Pisa Department of Surgical pays non établi dans la noticeUniversité ou école supérieure
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Azienda Ospedaliero-Universitaria Careggi pays non établi dans la noticeÉtablissement de santé
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Ospedale San Carlo pays non établi dans la noticeÉtablissement de santé
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Azienda Socio Sanitaria Territoriale della Valtellina e Alto Lario pays non établi dans la noticeÉtablissement de santé
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Department of Anesthesia and Critical Care Medicine pays non établi dans la noticeInstitution
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Intensive Care Unit and Regional ECMO Referral Center pays non établi dans la noticeInstitution
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San Carlo Hospital Cardiovascular Anesthesia and Intensive Care pays non établi dans la noticeÉtablissement de santé
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Anesthesia and Intensive Care pays non établi dans la noticeInstitution
Azienda Ospedaliera Universitaria Pisana, Department of Surgical — University of Pisa et Azienda Ospedaliero-Universitaria Careggi, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.