BACKGROUND A tracheostomy is often performed when patients cannot be weaned from mechanical ventilation. Respiratory infections (ventilator-associated pneumonia and infection of the lower respiratory tract) complicate the course of hospitalization in patients receiving mechanical ventilation. OBJECTIVES To evaluate respiratory infections before and after a percutaneous tracheostomy and to des...

BACKGROUND Tracheostomy is common in intensive care unit patients, but the appropriate timing is controversial. OBJECTIVE To determine whether earlier tracheostomy is associated with greater long-term survival. DESIGN Retrospective cohort analysis. SETTING Acute care hospitals in Ontario, Canada (n = 114). PATIENTS All mechanically ventilated intensive care unit patients who received tr...

Tracheostomy is one of the most frequently performed procedures in intensive care units. Bedside percutaneous tracheostomy has become an increasingly popular option to standard open tracheostomy. Several contraindications for percutaneous tracheostomy, including an enlarged thyroid isthmus, have been described. However, as experience with this technique has increased, most of the described cont...

INTRODUCTION Current prevalence estimates of gastrostomy tube (GT)/tracheostomy placement in hospitalized patients with anoxic/hypoxic ischemic encephalopathic injury (AHIE) post cardiopulmonary resuscitation (CPR) are unknown. We sought, to estimate the prevalence of AHIE in hospitalized patients who had CPR and to identify patient/hospital level factors that predict the performance of GT/trac...

A minority of patients with neuromuscular disease require placement of a tracheostomy, usually for the purpose of providing mechanical ventilation. Often the tracheostomy is performed during a hospital admission for an acute illness. The debate about the appropriate timing of tracheostomy in critically ill patients has not been resolved; however, the weight of evidence now favors performing a t...

Introduction Tracheostomy is the commonest surgical procedure in intensive care units (ICUs). It not only provides stable airway and facilitates pulmonary toilet and ventilator weaning, but also decreases the direct laryngeal injury of endotracheal intubation, and improves patient comfort and daily living activity. Objective The objective of this study is to assess the incidence, indications, t...

OBJECTIVE To examine the association between the performance of a tracheostomy and intensive care unit and postintensive care unit mortality, controlling for treatment selection bias and confounding variables. DESIGN Prospective, observational, cohort study. SETTING Twelve French medical or surgical intensive care units. PATIENTS Unselected patients requiring mechanical ventilation for > ...

OBJECTIVE This study aimed to determine the optimal time for tracheostomy by evaluating the benefits and safety of early versus late tracheostomy in spinal cord injury (SCI) patients. METHODS We retrospectively reviewed a total of 254 patients with spinal cord injury. Of them, we selected 21 spinal cord injury patients who required tracheostomy due to long-term mechanical ventilation and anal...

Intraluminal oesophageal pressures were measured in dogs after tracheostomy and intubation with either uncuffed or cuffed tracheostomy tubes. Possible explanations for disordered swallowing following tracheostomy were found in those animals intubated with cuffed tracheostomy tubes: (a) Increased intraluminal pressures were measured in the oesophagus at the level of the cuffs. (b) Significantly ...