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Tracheotomy

  • Sharmin Haque
  • Adam I. Levine
  • Chan W. Park
  • Kenneth W. Altman
Chapter

Abstract

Tracheostomy is commonly performed electively, urgently, or emergently in order to provide a definitive and secure airway. Patients requiring tracheostomy or those with a preexisting tracheostomy generally have significant comorbidities, specifically of the cardiovascular and pulmonary systems, that place them at increased risk in the perioperative period compared to the general population. In addition, despite having a “definitive airway,” patients with tracheotomies are still at risk of airway loss from device dislodgement or occlusion, compounded by a lack of familiarity with the post-surgical anatomy and/or the devices used for tracheostomy patency. Patients scheduled for tracheostomy placement and those with in situ tracheotomies present to the operating room frequently. Anesthesiologists must be knowledgeable of the tracheostomy procedure and the care of patients with tracheotomies and otolaryngologists must be knowledgeable of the impact of significant comorbidities on anesthetic management to assure optimal patient care and decrease perioperative morbidity and mortality. In this chapter we will review the surgical and anesthetic considerations for patients presenting for tracheostomy placement and those presenting to the operating room who already have atracheostomy. A special section will review in detail tracheostomy appliances and furnish the anesthesia caregiver with a working knowledge of these devises. As noted throughout this text, consistent planning and good communication between the otolaryngologist and anesthesiologist is vital to successful outcomes.

Keywords

Endotracheal Tube Laryngeal Mask Airway Subcutaneous Emphysema Tracheotomy Tube Tracheal Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Sharmin Haque
    • 1
  • Adam I. Levine
    • 2
  • Chan W. Park
    • 3
  • Kenneth W. Altman
    • 3
  1. 1.Department of AnesthesiologyChildren’s National Medical CenterWashington, DCUSA
  2. 2.Department of Anesthesiology, Otolaryngology and Structural & Chemical BiologyIcahn School of Medicine at Mount SinaiNew YorkUSA
  3. 3.Department of Otolaryngology – Head & Neck SurgeryIcahn School of Medicine at Mount SinaiNew YorkUSA

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