Abstract：
:Tracheostomy is one of the most commonly performed procedures in the ICU. Despite the frequency of the procedure, there remains controversy regarding selection of patients who should undergo tracheostomy, the optimal technique, timing of placement and decannulation, as well as impact on outcome associated with the procedure. A growing body of literature demonstrates that percutaneous tracheostomy performed in the ICU is a safe procedure, even in high risk patients. Advances in techniques, together with adjuncts to improve visualization, seem promising and likely to further improve the safety of the technique. Although there was initial enthusiasm in support of early tracheostomy to improve patient outcomes, repeated studies have been unable to produce robust benefits. The question of optimal timing and location of decannulation has not been answered, but there is some reassurance that in aggregate, across a variety of ICUs, patients do not appear to be harmed by transfer to ward with tracheostomy. Future research into techniques, timing, and termination of tracheostomy is warranted.
journal_name
Respir Carejournal_title
Respiratory careauthors
Bittner EA,Schmidt UHdoi
10.4187/respcare.01914subject
Has Abstractpub_date
2012-10-01 00:00:00pages
1626-34issue
10eissn
0020-1324issn
1943-3654journal_volume
57pub_type
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