title: [Indications for tracheotomy in long-term ventilated critically ill patients].
abstract: In order to evaluate the frequency and indication of tracheotomy in long-term ventilated critically ill patients we analysed retrospectively patients requiring artificial ventilation for periods of more than 7 days. During 1974-75 30 out of 55 of these patients were tracheotomised. In accordance with common practice, early tracheotomy (14 patients) was performed when ventilatory support was expected to exceed 8 to 10 days. In another 16 cases, the same limits were applicable for terminating prolonged tracheal intubation in favour of tracheotomy. In contrast, during the period 1980-81 tracheotomy had been indicated in 8 out of 94 patients. Early tracheotomy was limited to four patients with severe facial injuries accompanied by acute lung failure. The decision to perform tracheotomy or to continue prolonged tracheal intubation was based on definite findings during direct laryngoscopy and fibre bronchoscopy examination of the airways. No late laryngeal sequelae after prolonged tracheal intubation were observed. The risks have been reduced by the use of recently introduced tube materials. Prolonged tracheal intubation has become a safe alternative to tracheotomy.
mesh_terms: D003422:Critical Care; D005151:Facial Injuries / Q000150:complications; D006801:Humans; D007442:Intubation, Intratracheal; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D014140:Tracheotomy
vernacular_title: Die Indikationsstellung zur Tracheotomie beim langzeitbeatmeten Intensivpatienten.