The effect of very early tracheostomy versus early tracheostomy on weaning from mechanical ventilation in patient with moderate to severe traumatic brain injury- A Prospective randomized comparative study

Patients with TBI have to be admitted in intensive care unit (ICU) for comprehensive systemic and cerebral care. According to the CENTER-TBI study, 31% of TBI patients required tracheostomies. Traditionally, tracheostomies conducted within the first week are classified as early, whereas those performed after seven days are considered late. Early tracheostomy is thought to potentially reduce the duration of MV and the length of ICU stay. It may also decrease the risk of VAP and other complications associated with prolonged intubation. On the other hand, late tracheostomy might reduce the immediate risks associated with the procedure and allow for a better assessment of the patient’s potential for recovery. Therefore, lack of clarity underscores the need of further prospective studies to improve

outcome of TBI patients requiring tracheostomy. In our study,  traumatic brain injury patients will be be grouper as Group VE- Patients belong to group VE will get tracheostomy done in day 1 of admission to NTICU. Group ET- Patients belong to ET will get tracheostomy done on day 5 of admission to NTICU. Primary outcome - number of days to wean off from ventilator and also we study number of days patient takes to discharge,  occurrence ventilator associated pneumonia,  sepsis and any other complications in ICU.