Early Versus Late XXXX @entity1 : A Systematic Review and Meta-Analysis.

@entity1 @entity3124 @entity2489
OBJECTIVES: To compare outcomes of early tracheostomy ( <=10 days after translaryngeal intubation) with late tracheostomy (> 10 days after translaryngeal intubation) in @entity3124 @entity1 with prolonged mechanical ventilation (MV). METHODS: We searched PubMed, EMBASE and the Cochrane Library from inception to April 2014. We included all randomized controlled trials (RCTs) which compared early tracheostomy (ET) with late tracheostomy (LT) in @entity3124 @entity1 . There was no language restriction. Two authors extracted data and conducted a quality assessment. Meta-analyses using the fixed-effects or random-effects model were conducted for mortality, incidence of @entity2489 ( @entity2489 ), duration of MV and sedation, length of intensive care unit (ICU) stay. RESULTS: We enrolled nine studies, in which a total of 2040 @entity1 were randomized to either ET group (N=1018) or LT group (N=1022). ET might reduce the duration of sedation (weighted mean difference [WMD]=-5.99 days; 95% confidence intervals [CI]=-11.41- -0.57 days; p=0.03). ET did not significantly alter the mortality (relative risk [RR]=0.88; 95% CI=0.76-1.00; p=0.06), incidence of @entity2489 (RR=0.84; 95% CI=0.66-1.08; p=0.17), duration of MV (WMD=-4.46 days; 95% CI=-12.61-3.69 days; p=0.28) and length of ICU stay (WMD=-7.57 days; 95% CI=-15.42-0.29 days; p=0.06). CONCLUSIONS: Our meta-analysis suggested that ET might be able to reduce the duration of sedation but did not significantly alter the mortality, incidence of @entity2489 , duration of MV and length of ICU stay.
