No abstract

Improved operative and postoperative strategies to preserve myocardial function and restore hemodynamics should decrease the prevalence of ventilatory dependency. Unfortunately, preoperative models of ventilatory dependency are too insensitive for clinical use. Tracheostomy and its outcome are also poorly predicted, highlighting the complex interaction of events altering patients' conditions before and after tracheostomy.

Only one third of patients undergoing tracheostomy after cardiovascular surgery survive, because it is used primarily in those with deteriorating function of multiple organ systems. Although tracheostomy may enhance patient comfort and simplify nursing care, selection algorithms need to be developed if survival is the goal of the intervention.