Comparison of respiratory infections before and after percutaneous tracheostomy.


BACKGROUND A tracheostomy is often performed when patients cannot be weaned from mechanical ventilation. Respiratory infections (ventilator-associated pneumonia and infection of the lower respiratory tract) complicate the course of hospitalization in patients receiving mechanical ventilation. OBJECTIVES To evaluate respiratory infections before and after a percutaneous tracheostomy and to describe their outcomes. METHODS Medical records of adults who had percutaneous tracheostomy during a 1-year period at a tertiary care hospital in the southeastern United States were reviewed retrospectively. RESULTS Data for 322 patients were analyzed. Patients were predominately male (63.0%) and white (57.8%), with a mean age of 57.4 years. Ventilator-associated pneumonia or infection of the lower respiratory tract was identified in 90 patients (28.0%); the majority of infections were lower respiratory infections. Of all infections, 52% occurred before the tracheostomy, and 48% occurred after the procedure. Respiratory infections were associated with longer stays and higher costs, which were significantly higher in patients in whom the infection developed after the tracheostomy. Gram-negative organisms were responsible for the majority of infections. CONCLUSIONS Data related to respiratory infections that occurred before a tracheostomy were similar to data related to infections that occurred after a tracheostomy. Most infections were classified as lower respiratory infection rather than pneumonia. Infection, before or after a tracheostomy, resulted in longer stays and higher costs for care. Interventions focused on preventing infection before and after tracheostomy are warranted.

DOI: 10.4037/ajcc2014232

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@article{Sole2014ComparisonOR, title={Comparison of respiratory infections before and after percutaneous tracheostomy.}, author={Mary Lou Sole and Steven Talbert and Daleen Aragon Penoyer and Melody Bennett and Steven Sokol and Jason D Wilson}, journal={American journal of critical care : an official publication, American Association of Critical-Care Nurses}, year={2014}, volume={23 6}, pages={e80-7} }