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Intensive Care Medicine

, Volume 45, Issue 11, pp 1619–1621 | Cite as

What’s new in intensive care: tracheostomy—what is known and what remains to be determined

  • José Aquino Esperanza
  • Paolo Pelosi
  • Lluís BlanchEmail author
What's New in Intensive Care

Tracheostomy is done in 10–15% of patients undergoing mechanical ventilation (MV), and the prevalence has increased over the past 20 years [1]. The main indications are prolonged MV and difficult or prolonged weaning, and most patients requiring tracheostomy are admitted to the intensive care unit (ICU) for acute respiratory failure, coma, neuromuscular disease, or trauma. Percutaneous dilatational tracheostomy (PDT) can be performed in the ICU by non-surgeons, and clinical guidelines recommend this approach unless contraindicated [2].

Does tracheostomy affect lung mechanics?

Theoretically, tracheostomy could reduce inspiratory and expiratory resistive loads, because compared to endotracheal tubes (ETT), cannulae have larger inner diameters and are less susceptible to thermolabile deformation and obstruction due to secretions. Tracheostomy could also improve expiratory flow, thus minimizing intrinsic positive-end expiratory pressure (PEEPi). Both these factors should reduce the work of...

Notes

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Critical Care Center, Institut d’Investigació i Innovació Parc Taulí I3PTHospital Universitarí Parc TaulíSabadellSpain
  2. 2.Universitat de Barcelona, Facultat de MedicinaBarcelonaSpain
  3. 3.Department of Internal Medicine, Critical Care UnitCentro de Educación Médica e Investigaciones Clínicas CEMICBuenos AiresArgentina
  4. 4.Department of Surgical Sciences and Integrated DiagnosticsUniversity of GenoaGenoaItaly
  5. 5.Anesthesia and Intensive Care, IRCCS for Oncology and NeurosciencesSan Martino Policlinico HospitalGenoaItaly
  6. 6.Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES)Instituto de Salúd Carlos IIIMadridSpain
  7. 7.Universitat Autonoma de BarcelonaSabadellSpain

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