Early tracheostomy offers no significant improvement in survival without severe disability than the standard approach to tracheostomy in patients on mechanical ventilation following a severe stroke, a new study shows.
Researchers say that while the findings suggest both approaches are safe, there may still be advantages to delaying tracheostomy in these patients.
"Our results are neutral in the sense that there are no significant differences between the two with regard to long-term functional outcome," lead researcher Julian Bösel, professor of neurology, Heidelberg University Hospital, Heidelberg, Germany, told Medscape Medical News.
"But we found something that is very important, because for the first time there is evidence to show that there's nothing wrong with delaying tracheostomy and weaning patients to extubate them. Because by doing that, you can save a proportion of them from an invasive procedure," he added
The findings were presented May 4 at the European Stroke Organisation Conference (ESOC) 2022 Annual Meeting in Lyon, France, and published simultaneously online in the Journal of the American Medical Association May 4.
An End to the Controversy?
About 20%–30% of ventilated severe stroke patients require tracheostomy at some point, but just when to perform the procedure is controversial. Some prior studies have shown early tracheostomyimproves outcomes in critically ill patients, while others have found
