Meta-analysis of the effects of early tracheotomy on the prognosis of patients with severe craniocerebral injury / 重庆医学

ABSTRACT

Objective To evaluate the effects of early tracheotomy and delay tracheotomy on the prognosis of patients with severe craniocerebral injury.Methods Data of randomized controlled test (RCT) of early tracheotomy on the prognosis of the patients with severe craniocerebral injury were retrieved by using Conchrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIPdatahase.The retrievaled time was limited from their building to March 2016,and all the index of the obtained references was accessed.Two researchers independently screened the literature in accordance with the established criteria for inclusion or exclusion.The incidence of VAP,mechanical ventilation time and ICU length of hospital stay,mortality were considered as evaluation indexes.The methodology quality of the included references was evaluated,and the Meta-analysis was performed by using Review Manager 5.3 software.Results Finally,4 randomized controlled studies (RCT) were enrolled,including 220 patients.Meta-analysis results showed thatearly tracheotomy did not have any effects on VAP incidence rate (P=0.15) and fatality rate (P=0.20) of the patients with severe craniocerebral injury,there was not any statistically difference;but there was a statistically difference between the mechanical ventilation (P =0.01) and ICU hospitalization time (P =0.05).Conclusion Early tracheostomy could not significantly reduce the incidence of VAP and fatality rate of the patients with severe craniocerebral injury,but it can reduce the mechanical ventilation time and ICU hospitalization time.