• Mecker G Möller, Jason D Slaikeu, Pablo Bonelli, Alan T Davis, James E Hoogeboom, and Bruce W Bonnell.
• Grand Rapids/Michigan State University General Surgery Residency, Grand Rapids Medical Education and Research Center for the Health Professions, 221 Michigan St. N.E., Ste. 200-A, Grand Rapids, MI 49503, USA.
• Am. J. Surg. 2005 Mar 1;189(3):293-6.

BackgroundThis study's purpose was to determine if early tracheostomy (ET) of severely injured patients reduces days of ventilatory support, the frequency of ventilator-associated pneumonia (VAP), and surgical intensive care unit (SICU) length of stay (LOS).MethodsThis 2-year retrospective review included 185 SICU patients with acute injuries requiring mechanical ventilation and tracheostomy. ET was defined as 7 days or less, and late tracheostomy (LT) as more than 7 days.ResultsThe incidence of VAP was significantly higher in the LT group, relative to the ET group (42.3% vs. 27.2%, respectively; P <.05). Acute Physiology and Chronic Health Evaluation II scores, hospital and SICU LOS, and the number of ventilator days were significantly higher in the LT group.ConclusionsIn patients who required prolonged mechanical ventilation, there was significant decreased incidence of VAP, less ventilator time, and lower ICU LOS when tracheostomy was performed within 7 days after admission to the SICU.

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