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Only 24.8% of the patients did not receive any sedatives before tracheotomy, compared with 63.2% after tracheotomy (p < 0.01).
Propofol was used in 34.2% of the patients before tracheotomy, compared with 15.4% after tracheotomy (p < 0.01).
Of all patients, 62.4% needed morphine in the week before tracheotomy, compared with 32.5% in the week after tracheotomy (p < 0.01).
Similarly, the number of patients requiring sedation also decreased gradually before tracheotomy, and there was no significant difference in the number of patients receiving morphine, midazolam or propofol during the two days before tracheotomy compared with the two days after tracheotomy.
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The main purpose of our study was to assess whether precocious tracheotomy, compared with prolonged intubation, reduces the duration of ventilation, the frequency of nosocomial pneumopathy, the duration of hospitalization and the mortality.
NPPV use resulted in efficient gas exchange, a tendency to decrease ICU and hospital stays, and principally an important reduction in the incidence of pneumonia as well as in the need for tracheotomy when compared with conventional IMV weaning.
In addition, Rumbak and colleagues [ 23] showed that early tracheotomy, as compared with prolonged endotracheal intubation, shortens the duration of MV in ICU patients and decreases the number of days spent sedated.
We therefore conducted an updated systematic review and meta-analysis to evaluate the impact of early tracheotomy compared to late tracheotomy on outcome.
We investigated the potential benefits of early tracheotomy performed before day eight of mechanical ventilation (MV) compared with late tracheotomy (from day 14 if it still indicated) in reducing mortality, days of MV, days of sedation and ICU length of stay (LOS).
In this indication, no randomized study has evaluated the specific usefulness of early compared with late tracheotomy.
* P < 0.005, compared with before.
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