Tracheostomy in Acute and Chronic Respiratory Failure – Efficacy and Patient Outcomes

Open Access

Abstract

Background: In order to secure the airway, ease the transition from mechanical ventilation, and enhance patient comfort, tracheostomy is frequently performed in intensive care unit (ICU) patients with acute or chronic respiratory failure. However, there is still a lack of information from Bangladesh about patient outcomes and the best time to have a tracheostomy. The purpose of this study was to compare early versus late tracheostomy in this patient population and assess the efficacy, results, and problems of tracheostomy. Methods & Materials: This prospective observational study was conducted in the ICU and Otolaryngology-Head & Neck Surgery Department of a tertiary care hospital in Bangladesh from October 2024 to September 2025. This research involved forty adult patients needing tracheostomy for extended ventilation or airway safeguarding, gathering information on demographics, reasons, timing, complications, and results. Early tracheostomy was defined as a procedure performed within seven days of endotracheal intubation. Results: The average age was 58.4 ± 14.7 years, comprising 60% males. Acute respiratory failure and chronic respiratory failure comprised 57.5% and 42.5% of cases, respectively, with stroke (27.5%) and COPD (25%) being frequent underlying conditions. Extended ventilation was the primary reason (45%), and 65% had surgical tracheostomy performed. Following tracheostomy, the duration of mechanical breathing was reduced; 72.5% of patients were able to wean, 75% underwent decannulation, and the in-hospital mortality rate was 22.5%.Early tracheostomy was associated with shorter ICU stays, fewer days on ventilation, and higher rates of decannulation and weaning (all p < 0.05). Conclusion: Tracheostomy is a safe and beneficial procedure in critically ill patients, with early placement supporting quicker weaning and shorter ICU stays without added risk.