One-stage tracheostomy during surgery reduced early pulmonary infection and mechanical ventilation length in complete CSCI patients

This study investigates the effectiveness of performing a tracheostomy (a surgical procedure to create an opening in the trachea) during the initial surgery for patients with complete cervical spinal cord injury (CSCI). The study compares this approach to performing a tracheostomy later, if needed, after the surgery. The main goal was to see if early tracheostomy during surgery could reduce lung infections, shorten the time patients need mechanical ventilation, and decrease the length of their stay in the ICU and hospital. The researchers also aimed to identify factors that might indicate which patients with complete CSCI would benefit most from having a tracheostomy performed during their initial surgery.

• 1
  One-stage tracheostomy during surgery significantly reduced the development of pneumonia at 7 days after tracheostomy compared to necessary tracheostomy after surgery.
• 2
  Patients who underwent one-stage tracheostomy during surgery had a shorter length of mechanical ventilation, ICU LOS, and hospital LOS than the patients who underwent tracheostomy after surgery when it was necessary.
• 3
  A high neurological level of injury (NLI) (NLI C5 and above), a high PaCO2 in the blood gas analysis before tracheostomy, severe breathing difficulty, and excessive pulmonary secretions were the statistically significant factors for one-stage tracheostomy during surgery.