Semin Respir Crit Care Med 2014; 35(04): 482-491
DOI: 10.1055/s-0034-1383862
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tracheostomy in Mechanical Ventilation

Pierpaolo Terragni
1   Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy
,
Chiara Faggiano
1   Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy
,
Erica L. Martin
1   Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy
,
V. Marco Ranieri
1   Dipartimento di Scienze Chirurgiche, Università di Torino, Torino, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
11 August 2014 (online)

Abstract

Airway access for mechanical ventilation (MV) can be provided either by orotracheal intubation (OTI) or tracheostomy tube. During episodes of acute respiratory failure, patients are commonly ventilated through an orotracheal tube that represents an easy and rapid initial placement of the airway device. OTI avoids acute surgical complications such as bleeding, nerve and posterior tracheal wall injury, and late complications such as wound infection and tracheal lumen stenosis that may emerge due to tracheostomy tube placement. Tracheostomy is often considered when MV is expected to be applied for prolonged periods or for the improvement of respiratory status, as this approach provides airway protection, facilitates access for secretion removal, improves patient comfort, and promotes progression of care in and outside the intensive care unit (ICU). The aim of this review is to assess the frequency and performance of different surgical or percutaneous dilational tracheostomy and timing and safety procedures associated with the use of fiberoptic bronchoscopy and ultrasounds. Moreover, we analyzed the performance based on National European surveys to assess the current tracheostomy practice in ICUs.

 
  • References

  • 1 Cox CE, Carson SS, Holmes GM, Howard A, Carey TS. Increase in tracheostomy for prolonged mechanical ventilation in North Carolina, 1993-2002. Crit Care Med 2004; 32 (11) 2219-2226
  • 2 Groves DS, Durbin Jr CG. Tracheostomy in the critically ill: indications, timing and techniques. Curr Opin Crit Care 2007; 13 (1) 90-97
  • 3 Diehl JL, El Atrous S, Touchard D, Lemaire F, Brochard L. Changes in the work of breathing induced by tracheotomy in ventilator-dependent patients. Am J Respir Crit Care Med 1999; 159 (2) 383-388
  • 4 Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest 1985; 87 (6) 715-719
  • 5 Higgins KM, Punthakee X. Meta-analysis comparison of open versus percutaneous tracheostomy. Laryngoscope 2007; 117 (3) 447-454
  • 6 Freeman BD, Isabella K, Lin N, Buchman TG. A meta-analysis of prospective trials comparing percutaneous and surgical tracheostomy in critically ill patients. Chest 2000; 118 (5) 1412-1418
  • 7 Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care 2006; 10 (2) R55
  • 8 Frutos-Vivar F, Esteban A, Apezteguía C , et al; International Mechanical Ventilation Study Group. Outcome of mechanically ventilated patients who require a tracheostomy. Crit Care Med 2005; 33 (2) 290-298
  • 9 Terragni PP, Antonelli M, Fumagalli R , et al. Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA 2010; 303 (15) 1483-1489
  • 10 Mascia L, Corno E, Terragni PP, Stather D, Ferguson ND. Pro/con clinical debate: tracheostomy is ideal for withdrawal of mechanical ventilation in severe neurological impairment. Crit Care 2004; 8 (5) 327-330
  • 11 Bardell T, Drover JW. Recent developments in percutaneous tracheostomy: improving techniques and expanding roles. Curr Opin Crit Care 2005; 11 (4) 326-332
  • 12 Succo G, Crosetti E, Pecorari GC , et al. Complications of tracheostomy in critically ill patients: comparison of dilation and surgical techniques [in Italian]. Acta Otorhinolaryngol Ital 2002; 22 (4) (Suppl. 71) 1-11
  • 13 McWhorter AJ. Tracheotomy: timing and techniques. Curr Opin Otolaryngol Head Neck Surg 2003; 11 (6) 473-479
  • 14 Blot F, Melot C. Commission d'Epidémiologie et de Recherche Clinique. Indications, timing, and techniques of tracheostomy in 152 French ICUs. Chest 2005; 127 (4) 1347-1352
  • 15 Fikkers BG, Fransen GA, van der Hoeven JG, Briedé IS, van den Hoogen FJ. Tracheostomy for long-term ventilated patients: a postal survey of ICU practice in The Netherlands. Intensive Care Med 2003; 29 (8) 1390-1393
  • 16 Vargas M, Servillo G, Antonelli M , et al. Informed consent for tracheostomy procedures in intensive care unit: an Italian national survey. Minerva Anestesiol 2013; 79 (7) 741-749
  • 17 Krishnan K, Elliot SC, Mallick A. The current practice of tracheostomy in the United Kingdom: a postal survey. Anaesthesia 2005; 60 (4) 360-364
  • 18 Veenith T, Ganeshamoorthy S, Standley T, Carter J, Young P. Intensive care unit tracheostomy: a snapshot of UK practice. Int Arch Med 2008; 1 (1) 21
  • 19 Añón JM, Escuela MP, Gómez V, García de Lorenzo A, Montejo JC, López J. Use of percutaneous tracheostomy in intensive care units in Spain. Results of a national survey. Intensive Care Med 2004; 30 (6) 1212-1215
  • 20 Fischler L, Erhart S, Kleger GR, Frutiger A. Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland. Intensive Care Med 2000; 26 (10) 1428-1433
  • 21 Cabrini L, Monti G, Landoni G , et al. Percutaneous tracheostomy, a systematic review. Acta Anaesthesiol Scand 2012; 56 (3) 270-281
  • 22 Zgoda MA, Berger R. Balloon-facilitated percutaneous dilational tracheostomy tube placement: preliminary report of a novel technique. Chest 2005; 128 (5) 3688-3690
  • 23 Cianchi G, Zagli G, Bonizzoli M , et al. Comparison between single-step and balloon dilatational tracheostomy in intensive care unit: a single-centre, randomized controlled study. Br J Anaesth 2010; 104 (6) 728-732
  • 24 Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. BMJ 2005; 330 (7502) 1243
  • 25 Wang F, Wu Y, Bo L , et al. The timing of tracheotomy in critically ill patients undergoing mechanical ventilation: a systematic review and meta-analysis of randomized controlled trials. Chest 2011; 140 (6) 1456-1465
  • 26 Trouillet JL, Luyt CE, Guiguet M , et al. Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery: a randomized trial. Ann Intern Med 2011; 154 (6) 373-383
  • 27 Scales DC, Ferguson ND. Early vs late tracheotomy in ICU patients. JAMA 2010; 303 (15) 1537-1538
  • 28 Mascia L, Terragni P. Tracheostomy in ICU patients: question of timing is question of indication. Minerva Anestesiol 2011; 77 (12) 1137-1138
  • 29 Young D, Harrison DA, Cuthbertson BH, Rowan K. TracMan Collaborators. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA 2013; 309 (20) 2121-2129
  • 30 Kollig E, Heydenreich U, Roetman B, Hopf F, Muhr G. Ultrasound and bronchoscopic controlled percutaneous tracheostomy on trauma ICU. Injury 2000; 31 (9) 663-668
  • 31 Winkler WB, Karnik R, Seelmann O, Havlicek J, Slany J. Bedside percutaneous dilational tracheostomy with endoscopic guidance: experience with 71 ICU patients. Intensive Care Med 1994; 20 (7) 476-479
  • 32 Koitschev A, Paasch S, Plinkert PK. Ciaglia percutaneous dilatation tracheotomy with endoscopic control. Analysis of complication-fraught steps [in German]. HNO 1998; 46 (7) 678-683
  • 33 Marelli D, Paul A, Manolidis S , et al. Endoscopic guided percutaneous tracheostomy: early results of a consecutive trial. J Trauma 1990; 30 (4) 433-435
  • 34 Barba CA, Angood PB, Kauder DR , et al. Bronchoscopic guidance makes percutaneous tracheostomy a safe, cost-effective, and easy-to-teach procedure. Surgery 1995; 118 (5) 879-883
  • 35 Jackson LS, Davis JW, Kaups KL , et al. Percutaneous tracheostomy: to bronch or not to bronch—that is the question. J Trauma 2011; 71 (6) 1553-1556
  • 36 Dennis BM, Eckert MJ, Gunter OL, Morris Jr JA, May AK. Safety of bedside percutaneous tracheostomy in the critically ill: evaluation of more than 3,000 procedures. J Am Coll Surg 2013; 216 (4) 858-865 , discussion 865–867
  • 37 Muhammad JK, Major E, Wood A, Patton DW. Percutaneous dilatational tracheostomy: haemorrhagic complications and the vascular anatomy of the anterior neck. A review based on 497 cases. Int J Oral Maxillofac Surg 2000; 29 (3) 217-222
  • 38 Muhammad JK, Patton DW, Evans RM, Major E. Percutaneous dilatational tracheostomy under ultrasound guidance. Br J Oral Maxillofac Surg 1999; 37 (4) 309-311
  • 39 Karakitsos D, Labropoulos N, De Groot E , et al. Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 2006; 10 (6) R162
  • 40 Keenan SP. Use of ultrasound to place central lines. J Crit Care 2002; 17 (2) 126-137
  • 41 Silva S, Biendel C, Ruiz J , et al. Usefulness of cardiothoracic chest ultrasound in the management of acute respiratory failure in critical care practice. Chest 2013; 144 (3) 859-865
  • 42 Oveland NP, Lossius HM, Wemmelund K, Stokkeland PJ, Knudsen L, Sloth E. Using thoracic ultrasonography to accurately assess pneumothorax progression during positive pressure ventilation: a comparison with CT scanning. Chest 2013; 143 (2) 415-422
  • 43 Rajajee V, Fletcher JJ, Rochlen LR, Jacobs TL. Real-time ultrasound-guided percutaneous dilatational tracheostomy: a feasibility study. Crit Care 2011; 15 (1) R67
  • 44 Kluge S, Baumann HJ, Maier C , et al. Tracheostomy in the intensive care unit: a nationwide survey. Anesth Analg 2008; 107 (5) 1639-1643
  • 45 Vargas M, Servillo G, Arditi E , et al. Tracheostomy in Intensive Care Unit: a national survey in Italy. Minerva Anestesiol 2013; 79 (2) 156-164
  • 46 Angus DC. When should a mechanically ventilated patient undergo tracheostomy?. JAMA 2013; 309 (20) 2163-2164