Abstract
Discussion Forum (0)
ePoster
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
ePoster
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
Impact of Early Tracheostomy in Non-Neurologically Injured Patients: A Systematic Review and Meta-Analysis
Noemie Villemure-Poliquin
Abstract
Discussion Forum (0)
ePoster
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
ePoster
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
Topic: Liberating from the Vent
Noémie Villemure-Poliquin MD1,2, Paule Lessard-Bonaventure MD MSc FRCSC1,3, Thierry Rouleau-Bonenfant MS1, Olivier Costerousse PhD1, François Lauzier MD MSc1,4 FRCPC, Ryan Zarychanski MD MSc FRCPC5, Lynne Moore PhD6, Alexis F. Turgeon MD MSc FRCPC1,4
1Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
2Département d'Ophtalmologie et d'Oto-rhino-laryngologie – Chirurgie cervico-faciale, Faculté de Médecine, Université Laval, Québec, QC, Canada
3Département de chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada
4Département d'Anesthésiologie et de Soins Intensifs, Division de Soins Intensifs, Faculté de Médecine, Université Laval, Québec, QC, Canada
5Departments of Medicine and Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
6Department of Preventive and Social Medicine, Faculté de Médecine, Université Laval, Québec, QC, Canada
Centre de Recherche du CHU de Québec-Université Laval (Hôpital de l'Enfant-Jésus), Axe Santé des populations et pratiques optimales en santé (Traumatologie - Urgence - Soins Intensifs), Université Laval, Québec, QC, Canada
INTRODUCTION:
The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial issue, especially for non-neurologically injured patients that are more likely to require prolonged intubation due to respiratory failure. The primary objective of our systematic review and meta-analysis was to evaluate the effect of early versus late tracheostomy or prolonged intubation in non-neurologically injured patients.
Methods
We searched MEDLINE, CENTRAL, CINAHL, Web of science and Embase databases for randomized clinical trials (RCT) comparing early tracheostomy to late tracheostomy or prolonged intubation. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary outcome was overall mortality. Secondary outcomes included hospital and intensive care unit (ICU) lengths of stay (LOS), duration of mechanical ventilation (MV) and ventilator-associated pneumonia (VAP).
Results:
Our search strategy yielded 7023 citations, from which 8 RCTs (n = 2353) were included in our analysis. We observed a non-statistically significant reduction in overall mortality with early tracheostomy compared to late tracheostomy or prolonged intubation (RR = 0.89, 95%CI: 0.80-1.00; P = 0.05; I2 = 21%). Our results were consistent for the study population, the timing of outcome assessment and the risk of bias of trials. We found no difference in ICU and hospital LOS, duration of MV and VAP.
Conclusion:
In our systematic review of RCTs, we observed that early tracheostomy as compared to late tracheostomy or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
No references for this abstract.
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