Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recently published papers: Tracheostomy: why rather than when? Obesity: does it matter? And stroke: diagnosis, thrombosis and prognosis. | Available online http content 11 2 127 Commentary Recently published papers Tracheostomy why rather than when Obesity does it matter And stroke diagnosis thrombosis and prognosis Tim McCormick and Richard Venn Worthing Hospital Lyndhurst Road Worthing BN11 2DH UK Corresponding author Richard Venn Published 27 April 2007 Critical Care 2007 11 127 doi cc5725 This article is online at http content 11 2 127 2007 BioMed Central Ltd Abstract Three studies explore the case for tracheostomies in the intensive care unit ICU . Tracheostomies appear to have no effect on ICU survival according to a prospective observational cohort study that used a propensity score. In obese patients surgical tracheostomies were associated with an increased risk of complications although these patients appeared to have a lower mortality in the ICU. A third study failed to show that tracheostomies reduced sedation requirements. MRI appears to be the investigation of choice for the diagnosis of acute stroke and thrombolysis is a safe and effective treatment for acute ischaemic strokes. Virtually all patients with a stroke may benefit from ongoing care in a stroke unit. Tracheostomy why rather than when The benefits of a tracheostomy are generally accepted -reduced risk of laryngeal injury weaning from intermittent positive pressure ventilation IPPV less sedation improved patient comfort communication and oral hygiene and although risks exist they are thankfully rare. Early tracheostomy may improve survival although its impact remains controversial a controversy hopefully to be answered by the TracMan study 1 . The impact on morbidity mortality is difficult to assess as patient factors and events in the intensive care unit ICU lead to bias - so called confounding in indication - but by using a propensity score Clec h and colleagues 2 assessed the effect of a tracheostomy on mortality allowing for bias. In this prospective observational .
