EARLY TRACHEOSTOMY FACILITATES EARLY WEANING FROM MECHANICAL VENTILATOR IN SEVERE TRAUMATIC BRAIN INJURY PATIENT
Abu Tahir Moh’d Sahidullah Monsur*, Md. Ashiqul Muhit Khan, A. K. M Bazlul Karim, Md. Arif Hasan, Dibakar Chaudhury and Riad Habib
Background: Severe traumatic brain injury (TBI) patients are constantly submitted to interventions to cope secondary injury and insults. Oxygen therapy is mostly initiated by endotracheal intubation at the scene of the accident. Due to the severity of the trauma, prolonged mechanical ventilation is expected and tracheostomy (TQT) is often indicated. TQT became one of the most common bedside surgical procedure performed in an Intensive Care Unit (ICU). Objective: To evaluate the early tracheostomy facilitates early weaning from mechanical ventilator in severe traumatic brain injury patient. Materials and Methods: It was a prospective clinical study conducted at Enam Medical College & Hospital, Savar, Bangladesh from 2017-2021. A total of 65 patients admitted with Severe Traumatic Brain Injury were enrolled in this study. Data were collected using a structured questionnaire containing all the variables of interest. Data was processed and analyzed with the help of computer program SPSS for windows version 25. Results: This study show majority were male (92.3%) and female (7.7%). Common mode of injury were road traffic accident (67.7%) then fall from height (16.9%) and physical assault (9.2%). It observed maximum GCS were 7/15 (33.8%) then GCS of 8/15 (26.2%) and GCS 6/15 (18.4%). Maximum (44.6%) duration in ventilator 2 days followed 40% were 1 day and 13.8% were 3 days. Majority (78.5%) were shift to neuro surgery ward. 12.3% had taken DORB, 7.7% were death. Conclusion: It concluded that Early Tracheostomy, with severe traumatic brain injury patients could help in reducing duration in mechanical ventilation, reduce ICU and hospital stay. Study suggested that early tracheostomy, less than 48 hour after intubation should be performed if clinical and neurological stabilization was achieved in patients with severe TBI.
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