Ventilator-associated pneumonia and other tracheostomy-related outcomes in intensive care unit patients: a systematic review
Abstract
Objective: To systematically evaluate the impact of early tracheostomy on clinical outcomes compared to other therapeutic strategies in adult patients undergoing invasive mechanical ventilation (IMV) in intensive care units (ICUs), focusing on the incidence of ventilator-associated pneumonia (VAP), mortality, duration of ventilation, and ICU length of stay. Background: Prolonged MV increases the risk of complications, particularly VAP, which remains one of the leading causes of morbidity and mortality in critically ill patients. Tracheostomy has been widely employed to facilitate weaning from ventilation, reduce respiratory complications, and potentially lower the incidence of VAP. However, the optimal timing for its implementation remains controversial. Methods: A systematic review was conducted using the PubMed and Cochrane Library databases, including observational and interventional studies published within the last five years. Studies involving patients aged above 16 years and under MV were selected, comparing early tracheostomy with late tracheostomy or no tracheostomy. PROSPERO protocol registration number: CRD420250652487. Results: Twelve studies were included, encompassing a total of 158,677 patients. Most studies indicated that early tracheostomy was associated with reduced ventilation duration, shorter ICU stays and lower incidence of VAP, with an absolute reduction of up to 12%. Conversely, two studies reported a higher risk of VAP among tracheostomized patients.…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 158,677 participants or records.
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