title: Tracheostomy in mechanical ventilation.
abstract: Airway access for mechanical ventilation (MV) can be provided either by orotracheal intubation (OTI) or tracheostomy tube. During episodes of acute respiratory failure, patients are commonly ventilated through an orotracheal tube that represents an easy and rapid initial placement of the airway device. OTI avoids acute surgical complications such as bleeding, nerve and posterior tracheal wall injury, and late complications such as wound infection and tracheal lumen stenosis that may emerge due to tracheostomy tube placement. Tracheostomy is often considered when MV is expected to be applied for prolonged periods or for the improvement of respiratory status, as this approach provides airway protection, facilitates access for secretion removal, improves patient comfort, and promotes progression of care in and outside the intensive care unit (ICU). The aim of this review is to assess the frequency and performance of different surgical or percutaneous dilational tracheostomy and timing and safety procedures associated with the use of fiberoptic bronchoscopy and ultrasounds. Moreover, we analyzed the performance based on National European surveys to assess the current tracheostomy practice in ICUs.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Terragni
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Faggiano
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Martin
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy.
authors.forename: V Marco
authors.initials: VM
authors.lastname: Ranieri
mesh_terms: D000208:Acute Disease; D001999:Bronchoscopy / Q000379:methods; D005336:Fiber Optic Technology; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000379:methods*; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy; D013997:Time Factors; D014139:Tracheostomy / Q000379:methods*