Tracheostomy: epidemiology, indications | 合法醫療器材資訊網

由NHCheung著作·2014·被引用271次—Tracheostomyisacommonprocedureperformedincriticallyillpatientsrequiringprolongedmechanicalventilationforacuterespiratoryfailureandfor ...

Tracheostomy is a common procedure performed in critically ill patients requiring prolonged mechanical ventilation for acute respiratory failure and for airway issues. The ideal timing (early vs late) and techniques (percutaneous dilatational, other new percutaneous techniques, open surgical) for tracheostomy have been topics of considerable debate. In this review, we address general issues regarding tracheostomy (epidemiology, indications, and outcomes) and specifically review the literature regarding appropriate timing of tracheostomy tube placement. Based on evidence from 2 recent large randomized trials, it is reasonable to wait at least 10 d to be certain that a patient has an ongoing need for mechanical ventilation before consideration of tracheostomy. Percutaneous tracheostomy with flexible bronchoscopy guidance is recommended, and optimal percutaneous techniques, indications, and contraindications and result...