No between-group differences were noted http://www.selleckchem.com/products/Imatinib-Mesylate.html in weaning success or mortality between the groups. The length of stay, RCC length of stay, and the total number of mechanical ventilation days were significantly longer in the tracheostomy group (P = 0.04;P < 0.01; and P < 0.01, respectively).Table 4Case-matched study: summary of demographic and clinical variables in the tracheostomy and translaryngeal tube groupsDiscussionPrevious studies noted the need for specialized care units to manage respiratory rehabilitation [9]. Our study is the first to compare outcome between tracheostomized and translaryngeally intubated patients in a specialized regional weaning center for PMV. The fact that this investigation was undertaken in a specialized RCC reduced the influence of potential confounding factors, such as lack of staff experience and variability of setting, that are a problem in many studies.

Within our RCC, tracheostomy did not lead to increased weaning success as compared with translaryngeal intubation. Furthermore, our case-matched analysis revealed that no difference in either RCC or in-hospital mortality was present between the tracheostomy and translaryngeal tube-intubated patients. Multivariate analysis did reveal, however, that tracheostomy was a significant predictor of survival. Other studies have variously reported that tracheostomy is [8,10] and is not [9,11] associated with decreased ICU and in-hospital mortality rates. Further RCC studies are needed to confirm the findings regarding mortality and weaning success presented herein.

We also found that RCC and in-hospital lengths of stay and total MV days were significantly increased in tracheostomy compared with translaryngeally intubated patients. These findings are consistent with those of previous reports [8-10]. Whether decreased or increased length of stay is ultimately of benefit to the patient is dependent on the long-term results of treatment after leaving the hospital, something we did not measure.Our study also reports specific biochemical markers that may be suitable indictors for identifying tracheostomy candidates. Specifically, we found that patients with BUN levels lower than 40 (indicating adequate metabolic functioning) and albumin concentrations greater than 2.5 (indicating adequate nutritional status) were significantly more likely to be successfully weaned and survive.

On confirmation of these findings, assessment of the aforementioned markers may prove use in the clinical setting to facilitate the optimal Batimastat management of PMV patients.In this study, a significantly higher requirement for hemodialysis was found in the tracheostomy patients. Despite this, no corollary increase was found in the rate of mortality. This contrasts to the finding of Chao and colleagues [12], who reported that mortality was markedly increased in patients with concurrent PMV and renal-replacement therapy.