Why tracheostomy

Intubation is done when one cannot maintain their airway on their own due to anesthesia or illness. Often, a person is intubated for a short time, and a person would not go home when they are intubated.

Patients cannot be discharged with intubation and must have medical supervision. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure. Long-term complications are more likely the longer a tracheostomy is in place. These problems include:. If you still need a tracheostomy after you've left the hospital, you'll need to keep regularly scheduled appointments for monitoring possible complications. You'll also receive instructions about when you should call your doctor about problems, such as:.

How you prepare for a tracheostomy depends on the type of procedure you'll undergo. If you'll be receiving general anesthesia, your doctor may ask that you avoid eating and drinking for several hours before your procedure. You may also be asked to stop certain medications.

After the tracheostomy procedure, you'll likely stay in the hospital for several days as your body heals. If possible, plan ahead for your hospital stay by bringing:. A tracheotomy is most commonly performed in an operating room with general anesthesia, which makes you unaware of the surgical procedure. A local anesthetic to numb the neck and throat is used if the surgeon is worried about the airway being compromised from general anesthesia or if the procedure is being done in a hospital room rather than an operating room.

The type of procedure you undergo depends on why you need a tracheostomy and whether the procedure was planned. There are essentially two options:. For both procedures, the surgeon inserts a tracheostomy tube into the hole.

A neck strap attached to the face plate of the tube keeps it from slipping out of the hole, and temporary sutures can be used to secure the faceplate to the skin of your neck. You'll likely spend several days in the hospital as your body heals. During that time, you'll learn skills necessary for maintaining and coping with your tracheostomy:.

In most cases, a tracheostomy is temporary, providing an alternative breathing route until other medical issues are resolved. Crit Care Med. Article PubMed Google Scholar. Prolonged mechanical ventilation in critically ill patients: epidemiology, outcomes and modelling the potential cost consequences of establishing a regional weaning unit.

Crit Care. Outcomes of prolonged mechanic ventilation: a discrimination model based on longitudinal health insurance and death certificate data. Tracheostomy practice in adults with acute respiratory failure.

King C, Moores LK. Controversies in mechanical ventilation: when should a tracheotomy be placed? Clin Chest Med. Relationship between tracheotomy and ventilator-associated pneumonia: a case control study.

Eur Respir J. Blot F, Melot C. Commission d'Epidemiologie et de Recherche Clinique. Indications, timing, and techniques of tracheostomy in French ICUs. Use of tracheostomy in the PICU among patients requiring prolonged mechanical ventilation. Intensive Care Med. Timing of tracheostomy in critically ill patients: a meta-analysis. PloS One. The timing of tracheotomy in critically ill patients undergoing mechanical ventilation: a systematic review and meta-analysis of randomized controlled trials.

Effect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis. Lancet Respir Med. Tracheostomy: epidemiology, indications, timing, technique, and outcomes. Respir care. Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial.

The decision to extubate in the intensive care unit. Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation? Prolonged mechanical ventilation in a respiratory-care setting: a comparison of outcome between tracheostomized and translaryngeal intubated patients.

Tracheostomy does not improve the outcome of patients requiring prolonged mechanical ventilation: a propensity analysis. Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery: a randomized trial. Ann Intern med. Prolonged mechanical ventilation after cardiac surgery: outcome and predictors.

J Thorac Cardiovasc Surg. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Wei-Chieh Lin. WCL participated in the study design, collected data, analyzed data and wrote the manuscript. CWC was responsible for data collection and analysis.

JDW was responsible for study design, data analysis and manuscript revision. LMT was responsible for study design and manuscript revision. All authors read and approved the final manuscript.

Reprints and Permissions. Lin, WC. Is tracheostomy a better choice than translaryngeal intubation for critically ill patients requiring mechanical ventilation for more than 14 days? A comparison of short-term outcomes.

BMC Anesthesiol 15, Download citation. Back to Tracheostomy. A tracheostomy is sometimes needed if you're unable to breathe normally because of an underlying health condition or a blocked airway. A tracheostomy can deliver oxygen to the lungs if you cannot breathe normally.