Despite its frequency, tracheostomy in Swiss ICUs is far from being standardized with regard to indication, timing and choice of technique.

No abstract

Late outcome of percutaneous dilatational tracheostomy in critically ill patients is mostly good. Pending further studies, the use of this technique in intensive care units appears justified.

The analysis of standardized Test Breaths allows automatic determination of an initial ventilation pattern for intubated ICU patients. While this pattern does not seem to be superior to the one chosen by the conventional method, it is derived fully automatically and without need for manual patient data entry such as weight or height. This makes the method potentially useful as a start up procedure for closed-loop controlled ventilation.

Formal process analysis, followed by implementation of revised guidelines resulted in a significant reduction of 'door-to-needle time'. An initial dramatic but transient reduction of 'door-to-needle time' was considered observational and must not be mistaken as the definite new level of performance. We conclude that formal process analysis techniques are suited to improve processes in the intensive care unit.