During a 6-month period from October 2000 to March 2001, we analysed the indications, methods, waiting period and complications following a tracheostomy at the General Intensive Care Unit (GIGU) of Hospital Kuala Lumpur. There were 49 tracheostomies performed during this period. Thirty of them were performed in the GICU using the percutaneous dilatational method while 19 were performed elective...

BACKGROUND It is not clear whether the benefits of tracheostomy remain the same in the population. This study aimed to better examine the effect of tracheostomy on clinical outcome among prolonged ventilator patients. METHODS Data were from the medical claims data in Taiwan. A total of 3880 patients with ventilator use for more than 14 days between 2005 and 2009 were identified. Among them, 6...

Tracheostomy is one of the most frequent procedures performed on critically ill patients. It has advantages compared with translaryngeal endotracheal intubation, such as reduced laryngeal anatomical alterations, reduced inspiratory load, better tolerance by the patient and better nursing. Thus, tracheostomy can ease a patient's care in the event of prolonged respiratory support and difficult we...

Knowing when to change a tracheostomy tube is important for optimal management of all patients with tracheostomy tubes. The first tracheostomy tube change, performed 1-2 weeks after placement, carries some risk and should be performed by a skilled operator in a safe environment. The risk associated with changing the tracheostomy tube then usually diminishes over time as the tracheo-cutaneous tr...

Tracheostomy tube fracture resulting in airway obstruction is a relatively rare but serious complication. We report the case of a 48-year-old man whose tracheostomy tube fractured and became lodged in the right primary bronchus. Recommendations are made for tracheostomy care to help prevent similar complications in patients with an indwelling tracheostomy tube.

OBJECTIVE Early post-sternotomy tracheostomy is not infrequently considered in this era of percutaneous tracheostomy. There is, however, some controversy about its association with sternal wound infections. METHODS Consecutive patients who had percutaneous tracheostomy following median sternotomy for cardiac operation at our institution from March 1998 through January 2007 were studied, and c...

BACKGROUND Early tracheostomy can reduce the time required for mechanical ventilation, the duration of ICU stay, and treatment expenses. Choosing the optimal time for tracheostomy in patients with severe head injury is therefore important. The purpose of this study was to find the optimal time for tracheostomy according to Glasgow Coma Scale (GCS). MATERIALS AND METHODS In this prospective st...

BACKGROUND Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within 10 days of start of mechanical ventilation was compared with placement of t...

OBJECTIVE To provide an up-to-date review of pediatric tracheostomy, primarily focusing on indications, surgical technique, complications and hospital and home care. SOURCES MEDLINE and PubMed databases were searched using the following keywords: tracheostomy, tracheotomy, children, newborn. SUMMARY OF THE FINDINGS Indications for tracheostomy in children are changing. Today the most common...

BACKGROUND The morbidity of surgical tracheostomy performed in critically ill patients is not well-known. Accordingly, the aim of this prospective study was to determine the incidence and severity of complications associated with subthyroid tracheostomy and cricothyroidotomy when performed in the ICU. METHODS Over a 2-year period, individual consecutive patients who were undergoing an electiv...