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June 1988

Tracheostomy for Prolonged Intubation

Author Affiliations

Charleston, SC

Arch Otolaryngol Head Neck Surg. 1988;114(6):611. doi:10.1001/archotol.1988.01860180025006

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Brian E. Dougherty and W. Jarrard Goodwin, Jr, reported their experience with tracheostomy after prolonged intubation in 120 patients in the intensive care unit at the University of Miami Hospitals. In this January presentation to the Southern Section of the Triological Society, Birmingham, Ala, complications of tracheostomy in this very sick group of patients were only 10.8% (5% immediate, none fatal), and could not be correlated to the length of prior intubation. The overall mortality rate of 60% was related to the underlying disease and/or the patient's age, with elderly patients and those with pulmonary or septic problems faring poorer than those with only neurologic problems. Approximately two thirds of survivors tolerated decannulation. The authors concluded that tracheostomy was preferable to prolonged intubation for improved patient comfort and ease of care, and this should be a strongly favored procedure in patients having a substantial chance of surviving for more

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