• Thomas Namdar, Peter Leonard Stollwerck, Felix Hagen Stang, Karl-Friedrich Klotz, Thomas Lange, Peter Mailänder, and Frank Siemers.
• Department of Plastic Surgery, Hand Surgery, Burn Unit, University Hospital Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany. thomas.namdar@uk-sh.de
• Ger Med Sci. 2010 Jan 1;8:Doc10.

PurposeIn patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS) plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS.MaterialsA retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered.ResultsA retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52+/-19 years. Mean abbreviated burned severity index (ABSI) was 8.3+/-2.2. A mechanical ventilation was required for 14.3+/-4.8 days. TS was performed on day 7+/-4. Inspiratory oxygen concentration (FiO(2)) (p<0.001), peak inspiratory pressure (p<0.001), positive end-expiratory pressure (p=0.003) and pulmonary resistance (p<0.001) were reduced significantly after TS. The arterial partial pressure of oxygen/FiO(2)-ratio increased significantly after TS (p<0.001).ConclusionsWe demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.

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