{"title":"重型颅脑损伤延长机械通气早期气管切开术预防呼吸机相关性肺炎(VAP)","authors":"P. Ananda, Sony","doi":"10.20473/ijar.v4i22022.115-119","DOIUrl":null,"url":null,"abstract":"Introduction: Early tracheostomy needs to be considered if the use of a ventilator is expected to be used for a long time. Early Tracheostomy is recommended because it can improve respiratory function, reduce the risk of Ventilator-Associated Pneumonia, improve patient comfort, cleanse secretions in the throat, reduce laryngeal ulceration, improve mobilization, and speech efforts, and allow treatment outside the Intensive Care Unit (ICU). Case Report: We report four cases of severe head injury with early tracheostomy which illustrates prevent of VAP. In these four cases, early tracheostomy was performed (£ 4 days) with consideration of the initial critical GCS, the location of the lesion, and mechanical ventilation is expected to be used for a long period time. During treatment, there is no VAP which is evidenced by a sputum culture examination. Based on a meta-analysis study early tracheostomy can reduce mortality due to VAP by up to 50% and reduce the length of stay in ICU compared to delayed/late tracheostomy (> 10 days) or prolonged intubation (> 14 days). Conclusion: VAP prevention efforts are carried out by applying VAP Bundle. An early tracheostomy provides more benefits than prolonged intubation or delayed/late tracheostomy. VAP Bundle is performed on every patient who uses a ventilator, and it can be proven scientifically that the application of VAP Bundle can reduce the incidence of VAP by up to 25%.","PeriodicalId":117902,"journal":{"name":"Indonesian Journal of Anesthesiology and Reanimation","volume":"34 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early Tracheostomy in Prolonged Mechanical Ventilation Due to Severe Head Injury to Prevent Ventilator-Associated Pneumonia (VAP)\",\"authors\":\"P. Ananda, Sony\",\"doi\":\"10.20473/ijar.v4i22022.115-119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Early tracheostomy needs to be considered if the use of a ventilator is expected to be used for a long time. Early Tracheostomy is recommended because it can improve respiratory function, reduce the risk of Ventilator-Associated Pneumonia, improve patient comfort, cleanse secretions in the throat, reduce laryngeal ulceration, improve mobilization, and speech efforts, and allow treatment outside the Intensive Care Unit (ICU). Case Report: We report four cases of severe head injury with early tracheostomy which illustrates prevent of VAP. In these four cases, early tracheostomy was performed (£ 4 days) with consideration of the initial critical GCS, the location of the lesion, and mechanical ventilation is expected to be used for a long period time. During treatment, there is no VAP which is evidenced by a sputum culture examination. Based on a meta-analysis study early tracheostomy can reduce mortality due to VAP by up to 50% and reduce the length of stay in ICU compared to delayed/late tracheostomy (> 10 days) or prolonged intubation (> 14 days). Conclusion: VAP prevention efforts are carried out by applying VAP Bundle. An early tracheostomy provides more benefits than prolonged intubation or delayed/late tracheostomy. VAP Bundle is performed on every patient who uses a ventilator, and it can be proven scientifically that the application of VAP Bundle can reduce the incidence of VAP by up to 25%.\",\"PeriodicalId\":117902,\"journal\":{\"name\":\"Indonesian Journal of Anesthesiology and Reanimation\",\"volume\":\"34 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indonesian Journal of Anesthesiology and Reanimation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20473/ijar.v4i22022.115-119\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indonesian Journal of Anesthesiology and Reanimation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20473/ijar.v4i22022.115-119","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Early Tracheostomy in Prolonged Mechanical Ventilation Due to Severe Head Injury to Prevent Ventilator-Associated Pneumonia (VAP)
Introduction: Early tracheostomy needs to be considered if the use of a ventilator is expected to be used for a long time. Early Tracheostomy is recommended because it can improve respiratory function, reduce the risk of Ventilator-Associated Pneumonia, improve patient comfort, cleanse secretions in the throat, reduce laryngeal ulceration, improve mobilization, and speech efforts, and allow treatment outside the Intensive Care Unit (ICU). Case Report: We report four cases of severe head injury with early tracheostomy which illustrates prevent of VAP. In these four cases, early tracheostomy was performed (£ 4 days) with consideration of the initial critical GCS, the location of the lesion, and mechanical ventilation is expected to be used for a long period time. During treatment, there is no VAP which is evidenced by a sputum culture examination. Based on a meta-analysis study early tracheostomy can reduce mortality due to VAP by up to 50% and reduce the length of stay in ICU compared to delayed/late tracheostomy (> 10 days) or prolonged intubation (> 14 days). Conclusion: VAP prevention efforts are carried out by applying VAP Bundle. An early tracheostomy provides more benefits than prolonged intubation or delayed/late tracheostomy. VAP Bundle is performed on every patient who uses a ventilator, and it can be proven scientifically that the application of VAP Bundle can reduce the incidence of VAP by up to 25%.