Abstract: To summarize the application of tracheotomy in treatment of acute severe brain injuries, 37 cases of acute severe brain injury patients with tracheotomy admitted to the department in 1997 were analyzed. All the scores of GCS were 3 to 8 points. Fourteen cases accepted conservative treatment, other 23 cases with emergency operation. Sputum bacterial cultures and drug sensitive tests were routinely carried out after tracheotomy. Twenty seven cases survived and 10 were dead(27.0%). After tracheotomy, the respirations were improved in 35 cases(94.6%)and SaO₂ turned normal in 29 cases(78.4%). The bactera of pneumonia infections were commonly drug resistant. Tienam had the lowest resistant ratio(14.3%). Sputum bacterial culture should be done routinely after trachotomy and the drugs can be selected according the result. Transtrocheal medication of antibiotics is a safe and effective methold to treat pulmonary infection.

Key words: brain injuries, tracheotomy, sputum bacterial culture