Factors Influencing Choice Between Tracheostomy and Prolonged Translaryngeal Intubation in Acute Respiratory Failure

Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland

“…With the development of improved endotracheal tube design, the indication and timing of tracheostomy gradually changed. In the late 1970s and early 1980s different authors [8,9,10] compared translaryngeal intubation with tracheostomy. They reported more serious complications [8], a higher bacterial invasion of the lungs [9] and a high rate of tracheal stenosis [8,10] and, therefore, were often cited to support prolonged translaryngeal intubation.…”

Impact of Tracheostomy Timing on Outcome After Severe Head Injury

“…Data also support early weaning of mechanical ventilation within 48 h of early tracheostomy [2,6]. On the other hand, tracheostomy itself may result in various procedural complications ''early'' in a patient's course [7][8][9][10][11][12][13]. Some evidence also exists to suggest that early tracheostomy does not, in fact, improve outcome [8,14].…”

Mechanical ventilation of the patient with severe chronic obstructive pulmonary disease

“…A tracheostomy offers ~ the advantages of reducing laryngeal injury, allowing the patient to communicate and move more freely with a lessened risk of self-extubation and facilitates oral nourishment, pulmonary toilet and early ICU discharge. Complications include tracheal stenosis, a greater incidence of bacterial colonization [102], and postoperative complications such as pneumothorax, tracheo-innominate fistula, pneumothorax and death [100,101]. Good clinical data are lacking concerning the role of tracheostomy in the difficult-to-wean patient with COPD.…”