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May 27, 2007

My friend is in an ICU unit with PCP, CMV and MRSA and other "unspecified" infections. He has been on a ventilator/feeding tube for over 10 days and his doctor has asked me to OK a trach. From my research, this is not recommended for folks with PCP and the mortality rate is 100%. True? False? I have responsibility & power of attorney to make a yes or no decision -- and I am struggling the "best" thing to do for my friend's hopeful recovery. Even if your answer does not appear in time to help me make a decision -- perhaps it will help others in my tough position. Thank you.

Response from Dr. Holodniy

This is a very complex question to answer because undoubtably there are many variables in play here. In patients who might require longer ventilator support in order to recover lung function, it may be better to ventilate via a tracheostomy rather than an endotracheal tube. I don't think the pathogen would be the deciding factor for placing a tracheostomy.

viral load pattern

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