Clinical features as discriminating factors in the choice of tracheostomy techniques

Introduction Tracheostomy is a generally accepted procedure that assures free access to the airways in long-term lung ventilation. Apart from surgical tracheostomy, percutaneous dilational tracheostomy (PDT) has been increasingly employed in intensive care units (ICU). There is no optimal tracheostomy (TS) technique and in comparisons of percutaneous techniques, no single technique has proved to be superior. For this reason, the operator’s skill and experience and the clinical anatomical and physiopathological features of the patient should be discriminating factors in the choice of TS technique. Because of this we developed a decisional making algorithm as a guide to choose tracheostomy method more adapted to critical patients’ characteristics. It’s use in elective TS in ICU seems to reduce complications in our exeprience, regarding leterature data.