[Clinical study on the comparison of prophylactic tracheotomy with emergent tracheotomy after inhalation injury]

To compare prophylactic with emergent tracheostomy in 93 patients with inhalation injury, so as to explore the clinical significance of prophylactic tracheostomy.

Tracheostomy was applied in all patients with moderate and severe inhalation injury. The patients with obvious dyspnea, low oxygen pressure and decreased oxygen saturation before the operation were set to be emergent tracheostomy group (ET, n = 21), while those without dysfunction of ventilation and gas exchange, as prophylactic group (PT, n = 72). The average operation starting time was 4.31 +/- 3.04 PBH and 34.47 +/- 2.79 PBH in PT and ET groups, respectively.

There were evident decrease of blood oxygen pressure and oxygen saturation and increase of respiratory and heart rates before the tracheostomy in ET group, but all these signs improved after the operation. In contrary, the vital signs in PT group exhibited stable perioperatively. Assisted respiration with respirator was applied in 20 cases (95.24%) in ET and in 65 cases (90.28%) in PT groups within 2 post-operative days (POD).

Early and prophylactic tracheostomy should be advocated in patients suspected to be with moderate or severe inhalation injury. Emergent tracheostomy must be avoided and respiratory assistance should be employed as early as possible.