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See ((Tracheotomy))
Process of creating an artificial airway between the neck surface and cervical trachea.
Perfomed in patients with acute respiratory failure who require prolonged mechanical ventilation and or multiple attempts to wean ventilator have been unsuccessful for 14-21 days.
Decreases effort of breathing so patients can be weaned from ventilators.
Placement has little or no effect on dead space ventilation.
Decreases requirement for sedation and may allow earlier feeding, mobilization and institution of physical and occupational therapy.
Indications may include relief of upper airway obstruction, severe sleep apnea, difficult airway problems and clearance of pulmonary secretions.
Two main techniques: surgical dissection to form the tract between the neck surface and the trachea, and the percutaneous approach.
Lower rate of peristomal bleeding and infection with the percutaneous approach.
One third of patients with prolonged mechanical ventilation receive a tracheostomy.
Advantage of tracheostomy over prolonged translaryngeal endotracheal intubation include: increased patient comfort, decreased sedative use, faster weaning, decreased nosocomial pneumonia and shorter hospital stay.
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