Is there a positive effect on parallel canullamanegement and the weaning of ventilation? Or is there to less evidence of effectiveness?
Less sedation, better suctioning, most probably earlier separation from the ventilator.
Tracman study compared early versus late trachy, where no mortality benefit had been shown
http://jamanetwork.com/journals/jama/fullarticle/1690674
I agree with Dr Roshdy. Patients will be more comfortable, requiring less sedation. Dead space decreased, hence weaning may be easier- of course proof of mortality benefit in intensive care is a different ball game all together!
Early tracheostomy is preferred for situations like severe trauma or severe neurologic illness.The reason is protection from VAP when expected treatment time is long. This can minimise ICU stay and the removal to the ward safer under a prolonged weaning protocol of disconnection.
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