Role of early tracheostomy for preventing ventilator associated pneumonia in intensive care unit: a review

Abstract

The increasing number of the patients in ICU are well documented in the literature. Tracheostomy is a frequently performed surgical procedure among the critically ill patients in the ICU for reducing the duration of the sedation, increase of the comfort, shortening of the mechanical ventilation and minimizes the ICU stay. Performing early tracheostomy is a significant question for both intensivist and otolaryngologists to minimize the morbidity and mortality of the ICU patients. Prolonged intubated patients without performing of tracheostomy may result in injury of the respiratory tract other complications like ventilator associated pneumonia (VAP) and even sinusitis. VAP is a fatal complications associated with intubated patients in the ICU. There are different health care measures are done by intensivist for preventing the VAP such as adequate antibiotic protocols, bacterial decontamination of the oral cavity and pharynx, head positioning, early gastrostomy, hand disinfection, application of microbiological surveillance and monitoring or early removal of the invasive devices. Among these protocols, early trachesotomy is an important measure for reducing the risk of the VAP. It has been calculated that up to one-third of patients undergo mechanical ventilation at the ICU need tracheostomy. Early trachesotomy has been suggested for reducing the VAP in comparison to the translaryngeal intubation. However, the data from observational and randomized trial from different parts of the world are ABSTRACT