Abstract
Tracheostomy is a commonly performed procedure in Intensive Care Units (ICU’s), generally in critically ill patients with persistent respiratory failure. The main benefit of tracheostomy in this group is a reduction in the duration of mechanical ventilation. In addition, it might permit increased patient comfort, allowing patients to communicate, eat, and transfer to a chair while maintaining a secure airway. Given that the magnitude of the benefit depends on the timing of the procedure, performing a timely tracheostomy in patients who will actually require prolonged mechanical ventilation is ideal. Unfortunately clinicians are poor at predicting which patients will require prolonged mechanical ventilation. In order to prevent unnecessary tracheostomies, the procedure should be performed in a timely fashion, probably at least 10 days following endotracheal intubation. Provided that there are no contraindications, a percutaneous tracheostomy technique is a reasonable choice given the lower risk of infection when compared to surgical tracheostomy. Patients with severe neurological disease or those with upper airway obstruction constitute a unique group of patients, and are not covered in this chapter.
Original language | English (US) |
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Title of host publication | Mechanical Ventilation in Critically Ill Cancer Patients |
Subtitle of host publication | Rationale and Practical Approach |
Publisher | Springer International Publishing |
Pages | 255-264 |
Number of pages | 10 |
ISBN (Electronic) | 9783319492568 |
ISBN (Print) | 9783319492551 |
DOIs | |
State | Published - Jan 1 2018 |
ASJC Scopus subject areas
- General Medicine