Comparison Of Percutaneous Tracheostomy Vesus Surgical Tracheostomy For Complications In Critically Ill Patients:A Systematic Review

Objectives To compare the complication occurrence for percutaneous tracheostomy versus surgical tracheostomy in critically ill patients.Method Databases such as The Cochrane Library, PubMed,, CNKI, VIP and WanFang Data were electronically searched for randomized controlled trials(RCTs) on percutaneous tracheostomy vesus surgical tracheostomy, and the relevant references were also retrieved. According to the inclusion criteria, the data were extracted. Then the meta-analysis was conducted using RevMan5.29.Results A total of23RCTs were included. The results of meta-analyses showed that There was no statistically significant difference between the two groups for difficult decannulation[OR=1.93,95%CI(0.97-3.86), P=0.06, I2=26%],hemorrhage[OR=0.87,95%CI (0.56-1.37), P=0.56, I2=33%] and pneumothorax[OR=0.95,95%CI(0.38-1.78), P=0.91, I2=0%]. There were significantly fewer wound infections[OR=0.21,95%CI (0.13-0.35), P<0.01, I2=0%].Conclusion Our meta-analysis illustrates fewer wound infections in percutaneous tracheostomy but no difference in hemorrhage, difficult decannulation and pneumothorax. Current evidence were not enough to prove that percutaneous tracheostomy can replace surgical tracheostomy, and need more prospective, randomized studies.