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Early vs Standard Approach to Tracheostomy and Functional Outcome After Severe Stroke
To the Editor In the subgroup analysis of the recently published Stroke-Related Early Tracheostomy vs Prolonged Orotracheal Intubation in Neurocritical Care Trial 2 (SETPOINT2), the enrolled patients were divided into 3 subgroups according to their pathology diagnosis: acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. However, the type of stroke is not necessarily related to the need for tracheostomy. We believe it would be helpful to classify these patients based on the location of brain infarction, including distinct categories for brainstem or cerebellar stroke. The purpose of tracheostomy in...
Source: JAMA - September 13, 2022 Category: General Medicine Source Type: research

Early vs Standard Approach to Tracheostomy and Functional Outcome After Severe Stroke —Reply
In Reply In response to the Letters about SETPOINT2, we agree with Mr Li and Dr Zhou that the location and extent of the brain lesion(s) may be more related to tracheostomy need and timing than the exact vascular pathophysiology. This was in part our rationale for combining the 3 major stroke subtypes in the study population, assuming that by randomization differences in lesion location would be similarly distributed, as was the case between treatment groups. The suggestion to perform a post hoc subgroup analysis according to brain lesion location is appropriate, and that analysis is underway.
Source: JAMA - September 13, 2022 Category: General Medicine Source Type: research

Early vs Standard Approach to Tracheostomy and Functional Outcome in Patients With Severe Stroke
This multicenter clinical trial investigated potential benefits of early vs standard tracheostomy in patients with severe stroke receiving mechanical ventilation.
Source: JAMA - May 17, 2022 Category: General Medicine Source Type: research