Systematic Review and Meta-Analysis of Early versus Late Tracheostomy on Risk of Ventilator-associated Pneumonia Pubblico

Abstract

Objective

To compare the effect of early tracheotomy (ET) and late tracheotomy (LT) on ventilator-associated pneumonia (VAP) incidence and mortality in critically ill patients who received mechanical ventilation.

Method

We searched PubMed, Web of science and the Cochrane Central Register of Controlled Trials. We included randomized controlled trials (RCTs) and observational studies, which compared ET with LT in critically ill patients. Meta-analyses using the random-effects model were conducted for ventilator-associated pneumonia (VAP) and mortality.

Results

A total of 16 studies involving 2542 patients (895 in the ET group and 1647 in the LT group) were included in this analysis. Qualitative analyses show Early tracheotomy could reduce the VAP incidence and reduce the mortality. The meta-analysis showed that there is no significance difference between the ET and LT in the VAP and mortality incidence.

Table of Contents

 1.Introduction 1

2. Methodology 4

a. Search strategy and selection 4

b. Data extraction and analysis 5

3. Results 8

a. Study selection 8

b. Study characteristics 8

c. Primary outcome, Ventilator-Associated Pneumonia 10

d. Secondary outcome, Mortality 13

e. Publication Bias assessment 16

4. Discussion 18

5. Conclusion 19

References 20

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	intensive care unit; meta-analysis; mortality; tracheostomy; ventilator-associated pneumonia; VAP
Committee Chair / Thesis Advisor	McNabb, Scott , Emory University

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