title: Tracheostomy Update: When and How.
abstract: Tracheostomy remains one of the most commonly performed surgical procedures in the setting of acute respiratory failure. Tracheostomy literature focuses on 2 aspects of this procedure: when (timing) and how (technique). Recent trials have failed to demonstrate an effect of tracheostomy timing on most clinically important endpoints. Nonetheless, relative to continued translaryngeal intubation, studies suggest that tracheostomy use is associated with less need for sedation and enhanced patient comfort. Evidence likewise suggests that percutaneous dilational tracheostomy is advantageous with respect to cost and complication profile and should be considered the preferred approach in appropriately selected patients.
authors.affiliation: Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Box 8109, St Louis, MO 63110, USA. Electronic address: freemanb@wustl.edu.
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Freeman
mesh_terms: D006801:Humans; D012128:Respiratory Distress Syndrome / Q000628:therapy; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods*
keywords: Acute respiratory failure; Critical illness; Intensive care units; Percutaneous dilational tracheostomy; Practice variation; Tracheostomy