Outcome of Patients with Severe Traumatic Brain Injury: Tracheostomy and Associated Complications

Patients with severe traumatic brain injury (TBI) develop systemic clinical repercussions, mainly respiratory, with tracheostomy being one of the necessary interventions. This procedure offers benefits such as greater comfort and mobility, as well as, according to some studies, early weaning from mechanical ventilation. Objective: To evaluate the benefits and the ideal timing for performing tracheostomy in patients with severe TBI, determining its importance in clinical evolution, and to quantify associated complications, as well as the context of brain injury and its systemic repercussions. Methods: Retrospective observational study that evaluated, through patient medical records, the outcomes of patients with severe TBI at the Hospital de Clínicas de Passo Fundo between January 2016 and December 2018. Results: Patients who underwent early tracheostomy used antibiotics for an average of 18.5 days compared to 30.3 days for late tracheostomy. Regarding length of stay in the Intensive Care Unit, the early tracheostomy group remained an average of 14.4 days versus 16.7 days for the late tracheostomy group. For total hospital stay, the early tracheostomy group stayed an average of 25.9 days compared to 40.5 days for late tracheostomy. No significant difference in mortality was observed between the two groups. Conclusion: Early tracheostomy should be instituted in patients with severe TBI with the aim of improving their clinical outcomes.