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In mechanically ventilated patients with persistent respiratory failure, tracheotomy enhances patient comfort, facilitates ventilator weaning, minimizes airway trauma, and can prevent ventilator-associated pneumonia (VAP). Tracheotomy is recommended within 3 weeks after endotracheal intubation; however, optimal timing for tracheotomy is unknown, and practice patterns vary widely.
Researchers enrolled 419 patients with persistent respiratory failure in 12 Italian intensive care units; patients were randomized to early tracheotomy (6–8 days after intubation) or late tracheotomy (13–15 days after intubation). Exclusion criteria included preexisting pulmonary infections, chronic obstructive pulmonary disease, neck deformities, pregnancy, or hema…