• Ronny Ben-Avi, Alon Ben-Nun, Shany Levin, David Simansky, Nonna Zeitlin, Leonid Sternik, Ehud Raanani, and Alexander Kogan.
• Department of Thoracic Surgery, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
• J. Cardiothorac. Vasc. Anesth.. 2014 Jun 1;28(3):493-6.

ObjectivesThe optimal timing for tracheostomy after cardiac surgery in patients undergoing prolonged ventilation is controversial. The aim of this study was to assess the effect of tracheostomy timing on short- and long-term mortality of these patients.DesignRetrospective study of prospectively collected data.SettingCardiac surgical intensive care unit (ICU) in a tertiary-care, university-affiliated hospital.ParticipantsAll patients undergoing tracheostomy after cardiac surgery between September 2004 and March 2013 were included.InterventionsThe authors compared the outcome in 2 groups of patients according to the timing of tracheostomy: Group I, early-intermediate tracheostomy (0-14 days) and Group II, late tracheostomy (≥15 days).Measurements And Main ResultsDuring the study period, 6,069 patients underwent cardiac surgery; among them, 199 patients (3.26%) received a tracheostomy. There were 90 patients in Group I and 109 patients in Group II. There was no significant difference in the severity of the patients' illness between the groups. The mortality rate at 3 months, 6 months, 1 year, and 2 years was 37%, 48%, 56%, and 58% in Group I, respectively, and 58%, 70%, 74%, and 77% in Group II, respectively (p< 0.01).ConclusionsEarly-intermediate (0-14 days) tracheostomy after cardiac surgery in patients requiring prolonged mechanical ventilation was associated with reduced mortality compared with late tracheostomy (≥15 days).© 2013 Elsevier Inc. All rights reserved.

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