Timing of Tracheostomy
Tracheostomy is performed in critically ill adults requiring prolonged invasive ventilation as a strategy to: — reduce respiratory tract injury — improve patient comfort, and/or — to facilitate weaning
Category CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Fenestrated Tracheostomy Tube
fenestrated tracheostomy tube. allows patient to breath normally with a tracheostomy in situ. patient can cough and speak through mouth. improves swallow function. acts a step prior to decannulation
Tracheostomy ready for decannulation
Is this tracheostomy patient ready for decannulation? Hot Case
Weaning from Mechanical Ventilation
Ventilator management should be aimed at getting the patient off ventilator support as rapidly as possible. Weaning can be considered once the underlying process necessitating mechanical ventilation is resolving
Percutaneous Tracheostomy
Tracheostomy is an airway that is inserted subglottically through neck tissues directly into the trachea. Surgical Tracheostomy involves dissection and incision of trachea under direct vision.
Weaning from ventilation: Hot Case
Weaning from ventilation = Multi-factorial and list headings of causes -> clinical signs associated with list: Hot Case
Tracheostomy, advantages and disadvantages
Tracheostomy, advantages and disadvantages. Pro: reduced sedation requirement (greater comfort than oro-tracheal intubation). Con: requirement for a surgical procedure with inherent risk of complications
Tracheostomy Insertion Techniques
Approach to percutaneous dilatational tracheostomy (PDT) procedure
Tracheostomy Literature Summaries
Summary of evidence for PDT versus open tracheostomy. No difference in ICU or hospital mortality; duration of ventilation; nosocomial pneumonia
Percutaneous vs Surgical Tracheostomy
Percutaneous tracheostomy = reference to a number of different techniques to insert a tracheostomy (gradual dilation, forceps dilation, rhino and translaryngeal techniques)
Respiratory distress in Tracheostomy Patient
There are important considerations regarding tracheostomy management that differ from the standard approach to respiratory distress
PaO2/FiO2 Ratio (P/F Ratio)
PaO2/FiO2 ratio is the ratio of arterial oxygen partial pressure (PaO2 in mmHg) to fractional inspired oxygen (FiO2 expressed as a fraction, not a percentage)