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Table 2 Tracheostomy management and related complications according to the timing of tracheostomy

From: Tracheostomy management in patients with severe acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: an International Multicenter Retrospective Study

 

During ECMO tracheostomy (n = 353)

After ECMO tracheostomy (n = 177)

P

Interval ECMO-tracheostomy, days

8 (5–13)

16 (11–20)

< 0.01

Percutaneous dilatational tracheostomy

255 (72)

115 (65)

< 0.01

Mechanical ventilation the day of the tracheostomy

 FiO2, %

52 ± 16

44 ± 10

< 0.01

 Tidal volume, ml/kg PBW

4.3 ± 2.3

7.5 ± 2.3

< 0.01

 Total respiratory rate, breaths/min

20 ± 12

23 ± 9

0.06

 Plateau pressure, cmH2O

24 ± 4

24 ± 5

0.52

 Static compliance, ml/cm H2O

23 ± 17

36 ± 16

< 0.01

 PEEP, cmH2O

11 ± 4

8 ± 3

0.01

 Driving pressure, cmH2O

14 ± 4

15 ± 4

< 0.01

ECMO settings

 ECMO flow, L/min

3.3 ± 1.3

 

 Sweep gas flow, L/min

5.7 ± 3.0

 

 FdO2, %

96 ± 14

 

PaCO2, mmHg

42 ± 8

41 ± 8

0.25

Unfractionated Heparin consumption

 24 h before tracheostomy, UI/24 h

17,280 (8588–39,120)

5192 (0–33,920)

< 0.01

 24 h after tracheostomy, UI/24 h

1800 (600–13,000)

500 (0–1500)

< 0.01

Any early tracheostomy complications (first 24 h)

11 (3)

6 (3)

1.00

 Local bleeding requiring transfusion

4 (1)

0 (0)

0.30

 Pneumothorax

4 (1)

0 (0)

0.30

 Subcutaneous emphysema

1 (0.3)

1 (0.5)

1.00

 Tracheal rupture

1 (0.3)

2 (1)

0.36

 Failure

1 (0.3)

3 (2)

0.18

Any late tracheostomy complications

88 (38)

17 (17)

< 0.01

 Local bleeding

87 (25)

13 (7)

< 0.01

 Accidental tracheostomy decannulation

1 (0.3)

4 (2)

0.07

 Tracheomalacia

0 (0)

1 (1)

Delay tracheostomy-awake, days

4 (2–10)

2 (1–4)

< 0.01

Richmond Agitation Sedation Scale

 24 h before the tracheostomy

− 3 (− 4; − 2)

− 3 (− 4; − 1)

< 0.01

 24 h after the tracheostomy

− 3 (− 4; − 2)

− 2 (− 3; − 1)

< 0.01

  1. Results are presented as n (%), mean ± standard deviation, or median (25th–75th percentiles)
  2. ECMO, extracorporeal membrane oxygenation; FdO2, fraction of delivered oxygen; h, hour; MV, mechanical ventilation; PaCO2, partial pressure of arterial carbon dioxide; PBW, predicted body weight; PEEP, positive end-expiratory pressure