• Yuki Kishihara, Hideto Yasuda, Hidechika Ozawa, Fumihito Fukushima, Masahiro Kashiura, and Takashi Moriya.
• Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama-shi, Saitama, Japan. Electronic address: duke.amber.eyes6@gmail.com.
• J Crit Care. 2023 Oct 1; 77: 154299154299.

PurposeWe performed a network meta-analysis (NMA) of multiple tracheostomy timings using data from randomized control trials (RCTs) to investigate the impact on patient prognosis.Materials And MethodsWe searched MEDLINE, CENTRAL, ClinicalTrials.gov, and World Health Organization International Clinical Trials Platform Search Portal for RCTs on mechanically ventilated patients aged ≥18 years on February 2, 2023. We classified the timing of tracheostomy into three groups based on the clinical importance and previous studies: ≤ 4 days, 5-12 days, and ≥ 13 days. The primary outcome was short-term mortality, defined as mortality at any reported time point up to hospital discharge.ResultsEight RCTs were included. The results revealed no effect between ≤4 days vs. 5-12 days and 5-12 days vs. ≥ 13 days and a significant effect in ≤4 days vs. ≥ 13 days as follows: in ≤4 days vs. 5-12 days (RR, 0.79 [95% CI, 0.56-1.11]; very low certainty), ≤ 4 days vs. ≥ 13 days (RR, 0.67 [95% CI, 0.49-0.92]; very low certainty), and 5-12 days vs. ≥ 13 days (RR, 0.85 [95% CI, 0.59-1.24]; very low certainty).ConclusionsTracheostomy ≤4 days may result in lower short-term mortality than tracheostomy ≥13 days.Copyright © 2023 Elsevier Inc. All rights reserved.

12 keywords...

hide…