Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey

Area of Science:

• Critical Care Medicine
• Surgical Interventions
• Respiratory Management

Background:

• Tracheostomy is a frequent surgical procedure in intensive care units (ICUs) for patients needing prolonged mechanical ventilation.
• While offering benefits like reduced sedation and improved airway management, tracheostomy carries risks and lacks standardized clinical guidelines.
• This study addresses the need to understand tracheostomy prevalence, patient profiles, and outcomes in Italian ICUs.

Purpose of the Study:

• To determine the prevalence of tracheostomy among ICU patients in Italy.
• To evaluate patient characteristics, complication rates, and outcomes associated with tracheostomy.
• To identify the need for standardized clinical protocols for tracheostomy management.

Main Methods:

• An observational, cross-sectional, point-prevalence survey was conducted across eight Italian ICUs.
• Data were collected over two 24-hour periods, focusing on ICU and patient demographics, tracheostomy details, and complications.
• A total of 92 patients were surveyed, with 31 having undergone tracheostomy.

Main Results:

• The prevalence of tracheostomy was 9.1% (1.8 per 1000 admission days).
• Patients undergoing tracheostomy were older (mean age 59.5 years), predominantly male (67.7%), and often admitted for neurological conditions (48.4%).
• Tracheostomy occurred after a mean of 12.9 days of mechanical ventilation, primarily for weaning difficulties (64.5%), with observed complications and a 19.35% one-month mortality rate.

Conclusions:

• Tracheostomy plays a critical role in managing critically ill patients in Italian ICUs.
• High prevalence and complication rates necessitate the development of standardized clinical protocols to optimize outcomes.
• Further research is crucial for refining practices and establishing comprehensive tracheostomy management guidelines.