Tracheostomy: Indications

Georgie A Eapen, Macarena R. Vial

Research output: Chapter in Book/Report/Conference proceedingChapter

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 languageEnglish (US)
Title of host publicationMechanical Ventilation in Critically Ill Cancer Patients
Subtitle of host publicationRationale and Practical Approach
PublisherSpringer International Publishing
Pages255-264
Number of pages10
ISBN (Electronic)9783319492568
ISBN (Print)9783319492551
DOIs
StatePublished - Jan 1 2018

ASJC Scopus subject areas

  • General Medicine

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