Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey
<i>Background and Objectives</i>: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patien...
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2025-01-01
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| author | Raffaele Merola Maria Vargas Filippo Sanfilippo Marco Vergano Giovanni Mistraletti Luigi Vetrugno Gennaro De Pascale Elena Giovanna Bignami Giuseppe Servillo Denise Battaglini |
| author_facet | Raffaele Merola Maria Vargas Filippo Sanfilippo Marco Vergano Giovanni Mistraletti Luigi Vetrugno Gennaro De Pascale Elena Giovanna Bignami Giuseppe Servillo Denise Battaglini |
| author_sort | Raffaele Merola |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation. This study aimed to determine the prevalence of tracheostomy among ICU patients, while also evaluating patient characteristics, complication rates, and overall outcomes related to the procedure. <i>Materials and Methods</i>: We conducted an observational, cross-sectional, point-prevalence survey across eight ICUs in Italy. Data were collected over two 24 h periods in March and April 2024, with a focus on ICU characteristics, patient demographics, the details of tracheostomy procedures, and associated complications. <i>Results</i>: Among the 92 patients surveyed in the ICUs, 31 (33.7%) had undergone tracheostomy. The overall prevalence of tracheostomy was found to be 9.1%, translating to a rate of 1.8 per 1000 admission days. The mean age of patients with a tracheostomy was 59.5 years (SD = 13.8), with a notable predominance of male patients (67.7%). Neurological conditions were identified as the most common reason for ICU admission, accounting for 48.4% of cases. Tracheostomy procedures were typically performed after a mean duration of 12.9 days of mechanical ventilation, primarily due to difficulties related to prolonged weaning (64.5%). Both early and late complications were observed, and 19.35% of tracheostomized patients did not survive beyond one month following the procedure. The average length of stay in the ICU for these patients was significantly extended, averaging 43.0 days (SD = 34.3). <i>Conclusions</i>: These findings highlight the critical role of tracheostomy in the management of critically ill patients within Italian ICUs. The high prevalence and notable complication rates emphasize the urgent need for standardized clinical protocols aimed at optimizing patient outcomes and minimizing adverse events. Further research is essential to refine current practices and develop comprehensive guidelines for the management of tracheostomy in critically ill patients. |
| format | Article |
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| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-1cb0a121c82a42c982b05eca74bb43aa2025-01-24T13:40:33ZengMDPI AGMedicina1010-660X1648-91442025-01-016118710.3390/medicina61010087Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence SurveyRaffaele Merola0Maria Vargas1Filippo Sanfilippo2Marco Vergano3Giovanni Mistraletti4Luigi Vetrugno5Gennaro De Pascale6Elena Giovanna Bignami7Giuseppe Servillo8Denise Battaglini9Anesthesia and Intensive Care Medicine, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80138 Naples, ItalyAnesthesia and Intensive Care Medicine, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80138 Naples, ItalyDepartment of General Surgery and Medico-Surgical Specialties, School of Anaesthesia and Intensive Care, University of Catania, 95124 Catania, ItalyDepartment of Anesthesia and Intensive Care, San Giovanni Bosco Hospital, 10154 Torino, ItalySC Rianimazione e Anestesia, Ospedale Civile di Legnano, Azienda Socio Sanitaria Territoriale (ASST) Ovest Milanese, 20025 Milan, ItalyDepartment of Anesthesiology, Critical Care Medicine and Emergency, Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University Chieti-Pescara, 66013 Chieti, ItalyDipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 20123 Rome, ItalyAnesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, 43121 Parma, ItalyAnesthesia and Intensive Care Medicine, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80138 Naples, ItalyDepartment of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16126 Genova, Italy<i>Background and Objectives</i>: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation. This study aimed to determine the prevalence of tracheostomy among ICU patients, while also evaluating patient characteristics, complication rates, and overall outcomes related to the procedure. <i>Materials and Methods</i>: We conducted an observational, cross-sectional, point-prevalence survey across eight ICUs in Italy. Data were collected over two 24 h periods in March and April 2024, with a focus on ICU characteristics, patient demographics, the details of tracheostomy procedures, and associated complications. <i>Results</i>: Among the 92 patients surveyed in the ICUs, 31 (33.7%) had undergone tracheostomy. The overall prevalence of tracheostomy was found to be 9.1%, translating to a rate of 1.8 per 1000 admission days. The mean age of patients with a tracheostomy was 59.5 years (SD = 13.8), with a notable predominance of male patients (67.7%). Neurological conditions were identified as the most common reason for ICU admission, accounting for 48.4% of cases. Tracheostomy procedures were typically performed after a mean duration of 12.9 days of mechanical ventilation, primarily due to difficulties related to prolonged weaning (64.5%). Both early and late complications were observed, and 19.35% of tracheostomized patients did not survive beyond one month following the procedure. The average length of stay in the ICU for these patients was significantly extended, averaging 43.0 days (SD = 34.3). <i>Conclusions</i>: These findings highlight the critical role of tracheostomy in the management of critically ill patients within Italian ICUs. The high prevalence and notable complication rates emphasize the urgent need for standardized clinical protocols aimed at optimizing patient outcomes and minimizing adverse events. Further research is essential to refine current practices and develop comprehensive guidelines for the management of tracheostomy in critically ill patients.https://www.mdpi.com/1648-9144/61/1/87intensive care unit (ICU)mechanical ventilationoutcomespoint prevalencetracheostomy |
| spellingShingle | Raffaele Merola Maria Vargas Filippo Sanfilippo Marco Vergano Giovanni Mistraletti Luigi Vetrugno Gennaro De Pascale Elena Giovanna Bignami Giuseppe Servillo Denise Battaglini Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey Medicina intensive care unit (ICU) mechanical ventilation outcomes point prevalence tracheostomy |
| title | Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey |
| title_full | Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey |
| title_fullStr | Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey |
| title_full_unstemmed | Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey |
| title_short | Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey |
| title_sort | tracheostomy practice in the italian intensive care units a point prevalence survey |
| topic | intensive care unit (ICU) mechanical ventilation outcomes point prevalence tracheostomy |
| url | https://www.mdpi.com/1648-9144/61/1/87 |
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