Tracheostomy in burns patients revisited

Area of Science:

• Burns Management
• Critical Care Medicine
• Surgical Procedures

Background:

• Tracheostomy use in ventilated burn patients remains debated.
• Assessing its complications and outcomes is crucial for patient care.

Purpose of the Study:

• To evaluate the use, complications, and outcomes of tracheostomy in adult burn patients requiring mechanical ventilation.
• To compare tracheostomy with translaryngeal intubation in this patient population.

Main Methods:

• Retrospective data collection on burn extent, tracheostomy indications, and patient outcomes.
• Outcomes measured included length of stay, mechanical ventilation duration, complications, and survival.
• Patients were followed until discharge or death.

Main Results:

• Tracheostomy use was higher in patients with Total Burn Surface Area (TBSA) >60%.
• Patients undergoing tracheostomy had higher rates of inhalation injury and lower survival probability (ABSI).
• The tracheostomy group experienced longer mechanical ventilation, extended hospital stays, and increased pulmonary sepsis, but no difference in mortality.

Conclusions:

• Severe burns (TBSA >60%) increase the need for tracheostomy due to surgery and head/neck involvement.
• Tracheostomy is safe with few perioperative issues, but late complications correlate with ventilation duration and airway burns.
• Higher chest infection rates in the tracheostomy group are likely multifactorial, linked to burn severity and ventilation.