OTO: Early versus Late Tracheostomy: A Systematic Review and Meta-Analysis

This podcast highlights a systematic review and meta-analysis published in the February 2015 issue of Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief John Krouse is joined by authors Carrie Liu and Joseph Dort and associate editor Jennifer Shin in discussing the issue of early vs. late tracheostomies and its impact on clinical indicators such as length of stay in intensive care units (ICUs).   One question that is often debated is whether it is preferential to perform tracheostomies early in the course of an illness among intubated ICU patients, or whether it is preferential to delay these procedures to avoid the potential complications that might occur following tracheostomy.  In this paper, the authors performed a systemic review of the literature and selected 11 papers for inclusion.  In a meta-analysis of these studies, the authors noted that there was a significant decrease in length of ICU stay among patients receiving an early tracheostomy.  There was no difference noted in overall mortality between the two groups.  The currently available data were considered insufficient to discuss differences in indices such as incidence of pneumonia or occurrence of laryngotracheal injury.  The authors discuss the important implications of their findings and offer discussion about the need for further research in this important area.  Click here to read the full article.