Effect of early tracheotomy on patients with tuberculous meningitis who need invasive mechanical ventilation

doi:10.19871/j.cnki.xfcrbzz.2026.03.006

Abstract

Abstract: Objective To explore the effect of early tracheostomy(ET) on patients with tuberculous meningitis requiring invasive mechanical ventilation(IMV). Method A case-control study was conducted. Patients with tuberculous meningitis who received IMV treatment in the Intensive Care Unit of Chengdu Public Health Clinical Medical Center from January 2022 to December 2024 were enrolled. Patients undergoing ET were assigned to the ET group(n=29), and those receiving late tracheostomy during the same period were set as the control group(n=58). Epidemiological characteristics, comorbidities, neurological complications, the highest Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score within 48 hours after ICU admission, the initial Glasgow coma scale(GCS) score upon ICU admission, indications for IMV initiation, laboratory parameters before IMV, analgesia duration, duration of IMV, IMV-related complications, length of ICU stay, and 28-day in-hospital clinical outcomes (survival and death) were collected and compared between the two groups. Result Repeated aspiration caused by poor airway clearance was the leading indication for IMV support in patients with tuberculous meningitis. Compared with the control group, the ET group presented significantly shorter sedation duration, IMV duration and ICU stay length [(8.8±1.9）d vs (12.7±2.6)d, P<0.001; median:10.2d vs 16.4d, P<0.001; median:12.3d vs 17.5d, P<0.001]. There were no significant differences between the two groups in the incidence of ventilator-associated pneumonia, pneumothorax, subcutaneous emphysema, mediastinal emphysema, airway hemorrhage, airway stenosis, tracheoesophageal fistula, and 28-day in-hospital prognosis (P>0.05). Conclusion For patients with tuberculous meningitis requiring IMV, early tracheostomy can shorten sedation duration, IMV duration and ICU stay length, while it cannot improve the 28-day in-hospital prognosis.

Key words: Early tracheotomy, Invasive mechanical ventilation, Tuberculous meningitis, Intensive care, Prognosis

CLC Number:

R529.3

Cheng Yao, Wu Guihu, Mao Yi, Luo Haixia, Li Yuke. Effect of early tracheotomy on patients with tuberculous meningitis who need invasive mechanical ventilation[J]. Electronic Journal of Emerging Infectious Diseases, 2026, 11(3): 30-35.

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