Tracheostomy Timing, Indications and Complications in Critically Ill Patient

Abstract

Tracheostomy refers to the creation of a stoma at the skin surface, which leads to the trachea. Percutaneous bedside tracheostomy (PBT) is a one of the common and safe procedures in intensive care units through the world. It is safe and similar outcome in comparison to open surgical tracheostomy method in operation room by ENT team. ’Early’ and ’late’ tracheostomies are two categories of the timing of tracheostomy. Tracheostomy is indicated in long-term mechanical ventilation, mechanical obstruction of the upper airways, Protection of tracheobronchial tree in patients at risk of aspiration, respiratory failure, retention of bronchial secretions and elective tracheostomy. Complications are best considered to be immediate (within the first 24 h) eg. Haemorrhage, air embolism and apnea, intermediate complications (while the patient is still in hospital and within the first 4 weeks) eg. Surgical Emphysema and pneumothorax and late complications (after discharge) eg. tracheal stenosis, tracheocutaneous fistula. Decannulation can be carried out when the patient is not dependent on ventilatory support and has an adequate respiratory reserve, the patient is able to cough and swallow effectively and manage their own secretions whilst being able to protect their own airway the patient is able to cough and clear his / her tracheal secretions.

Key words Tracheostomy ,critically, patient