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Observational Study
. 2025 Jan 7;61(1):87.
doi: 10.3390/medicina61010087.

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

Raffaele Merola  1 , Maria Vargas  1 , Filippo Sanfilippo  2 , Marco Vergano  3 , Giovanni Mistraletti  4 , Luigi Vetrugno  5 , Gennaro De Pascale  6   7 , Elena Giovanna Bignami  8 , Giuseppe Servillo  1 , Denise Battaglini  9   10
Affiliations
Observational Study

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

Raffaele Merola et al. Medicina (Kaunas). .

Abstract

Background and Objectives: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation. This study aimed to determine the prevalence of tracheostomy among ICU patients, while also evaluating patient characteristics, complication rates, and overall outcomes related to the procedure. Materials and Methods: We conducted an observational, cross-sectional, point-prevalence survey across eight ICUs in Italy. Data were collected over two 24 h periods in March and April 2024, with a focus on ICU characteristics, patient demographics, the details of tracheostomy procedures, and associated complications. Results: Among the 92 patients surveyed in the ICUs, 31 (33.7%) had undergone tracheostomy. The overall prevalence of tracheostomy was found to be 9.1%, translating to a rate of 1.8 per 1000 admission days. The mean age of patients with a tracheostomy was 59.5 years (SD = 13.8), with a notable predominance of male patients (67.7%). Neurological conditions were identified as the most common reason for ICU admission, accounting for 48.4% of cases. Tracheostomy procedures were typically performed after a mean duration of 12.9 days of mechanical ventilation, primarily due to difficulties related to prolonged weaning (64.5%). Both early and late complications were observed, and 19.35% of tracheostomized patients did not survive beyond one month following the procedure. The average length of stay in the ICU for these patients was significantly extended, averaging 43.0 days (SD = 34.3). Conclusions: These findings highlight the critical role of tracheostomy in the management of critically ill patients within Italian ICUs. The high prevalence and notable complication rates emphasize the urgent need for standardized clinical protocols aimed at optimizing patient outcomes and minimizing adverse events. Further research is essential to refine current practices and develop comprehensive guidelines for the management of tracheostomy in critically ill patients.

Keywords: intensive care unit (ICU); mechanical ventilation; outcomes; point prevalence; tracheostomy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Characteristics of respiratory support according to type of airway. NIV = non-invasive ventilation, IMV = invasive mechanical ventilation, O2 = oxygen, TT = tracheal tube, TC = tracheostomy cannula, NA = natural airway.
Figure 2
Figure 2
Type of tracheostomy technique and cannula used.
Figure 3
Figure 3
(A) Early complications of tracheostomies performed. (B) Late complications of tracheostomies performed. SaO2 = saturation of oxygen.
See this image and copyright information in PMC

References

    1. Vargas M., Sutherasan Y., Antonelli M., Brunetti I., Corcione A., Laffey J.G., Putensen C., Servillo G., Pelosi P. Tracheostomy procedures in the intensive care unit: An international survey. Crit. Care. 2015;19:291. doi: 10.1186/s13054-015-1013-7. - DOI - PMC - PubMed
    1. Battaglini D., Premraj L., White N., Sutt A.L., Robba C., Cho S.M., Di Giacinto I., Bressan F., Sorbello M., Cuthbertson B.H., et al. Tracheostomy outcomes in critically ill patients with COVID-19: A systematic review, meta-analysis, and meta-regression. Br. J. Anaesth. 2022;129:679–692. doi: 10.1016/j.bja.2022.07.032. - DOI - PMC - PubMed
    1. Piombino P., Troise S., Vargas M., Marra A., Buonanno P., Fusetti S., Apolloni F., Crimi S., Bianchi A., Mariniello D., et al. A systematic review of the literature on the role of tracheostomy in COVID-19 patients. Eur. Rev. Med. Pharmacol. Sci. 2020;24:12558–12574. - PubMed
    1. Merola R., Iacovazzo C., Troise S., Marra A., Formichella A., Servillo G., Vargas M. Timing of Tracheostomy in ICU Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Life. 2024;14:1165. doi: 10.3390/life14091165. - DOI - PMC - PubMed
    1. Battaglini D., Missale F., Schiavetti I., Filauro M., Iannuzzi F., Ascoli A., Bertazzoli A., Pascucci F., Grasso S., Murgolo F., et al. Tracheostomy Timing and Outcome in Severe COVID-19: The WeanTrach Multicenter Study. J. Clin. Med. 2021;10:2651. doi: 10.3390/jcm10122651. - DOI - PMC - PubMed

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