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Timing of tracheostomy in adult patients: Authors' reply

BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7513.404-b (Published 11 August 2005) Cite this as: BMJ 2005;331:404
  1. J Duncan Young, consultant ([email protected]),
  2. John Griffiths, specialist registrar,
  3. Vicki Barber, trial coordinator,
  4. Lesley Morgan, trial coordinator
  1. Adult Intensive Care Unit, John Radcliffe Hospital, Oxford OX3 9DU
  2. Adult Intensive Care Unit, John Radcliffe Hospital, Oxford OX3 9DU
  3. Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital

    EDITOR—Philpott et al comment that tracheostomies carry an operative risk that is amplified by the severe illness precipitating admission to the intensive care unit. We estimated this risk when planning the TracMan trial of early versus late tracheostomy by reviewing 110 published case series of tracheostomy. Average operative mortality was 0.3% (www.ics.ac.uk/default2.htm and follow links). The overall mortality in intensive care in patients receiving a tracheostomy was 38.1% and in UK intensive care units, 20.1% (data at link above).

    Thus even a modest reduction in mortality in …

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