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Tracheostomy (Tracheotomy)

Surgery to create an opening (stoma) into the windpipe. The opening itself may also be called a tracheostomy.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

Tracheostomy

A tracheostomy is a surgically made hole that goes through the front of your neck into your trachea, or windpipe. A breathing tube, called a trach tube, is placed through the hole and directly into your windpipe to help you breathe. A tracheostomy may be used to help people who need to be on ventilators for more than a couple of weeks or who have conditions that block the upper airways.

A surgeon can make a tracheostomy in a hospital operating room when you are asleep from general anesthesia. A doctor or emergency medical technician can make a tracheostomy safely at a patient's bedside, such as in the intensive care unit (ICU), or elsewhere in a life-threatening situation.

A tracheostomy usually takes 20 to 45 minutes to perform. The surgeon or other health care professional will make a cut through the lower front part of your neck and then cut into your windpipe. Cuffed trach tubes may be used. These tubes use air to widen or narrow the tube to fit the hole. After inserting and placing the trach tube into the windpipe, the surgeon or other health care professional will use stitches, surgical tape, or a Velcro band to hold the tube in place....Read more about Tracheostomy
NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

Timing of tracheostomy for critically ill patients who are predicted to be on long‐term artificial respiration

Review question: We reviewed available evidence on the effects of early tracheostomy (≤ 10 days after tracheal intubation) as compared with late tracheostomy (> 10 days after tracheal intubation) in terms of mortality in critically ill patients who predicted to be on long‐term artificial respiration.

Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients

Critically ill adult patients in intensive care units (ICUs) often require mechanical respiration. Initially, patients are ventilated using an endotracheal tube (ETT). However, patients receiving long‐term ventilation often also require a tracheostomy. This procedure involves creating an opening in the neck and trachea, making it possible to circumvent the upper respiratory tract. A tracheostomy tube is then inserted into this opening. The aim of this procedure is to minimize complications such as scarred constrictions in the upper section of the trachea or damage to the larynx. In 1985, percutaneous dilatational tracheostomy (PDT) was established as a bedside procedure and is now one of the most common surgical procedures performed on the ICU.

Tracheostomy teams reduce total tracheostomy time and increase speaking valve use: a systematic review and meta-analysis

PURPOSE: Multidisciplinary tracheostomy teams have been implemented in acute hospitals over the past 10 years. This systematic review of the literature and meta-analysis aimed to assess the effect of tracheostomy teams on patient outcomes.

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Summaries for consumers

Timing of tracheostomy for critically ill patients who are predicted to be on long‐term artificial respiration

Review question: We reviewed available evidence on the effects of early tracheostomy (≤ 10 days after tracheal intubation) as compared with late tracheostomy (> 10 days after tracheal intubation) in terms of mortality in critically ill patients who predicted to be on long‐term artificial respiration.

Laryngeal mask airway versus endotracheal tube for percutaneous dilatational tracheostomy in critically ill adult patients

Critically ill adult patients in intensive care units (ICUs) often require mechanical respiration. Initially, patients are ventilated using an endotracheal tube (ETT). However, patients receiving long‐term ventilation often also require a tracheostomy. This procedure involves creating an opening in the neck and trachea, making it possible to circumvent the upper respiratory tract. A tracheostomy tube is then inserted into this opening. The aim of this procedure is to minimize complications such as scarred constrictions in the upper section of the trachea or damage to the larynx. In 1985, percutaneous dilatational tracheostomy (PDT) was established as a bedside procedure and is now one of the most common surgical procedures performed on the ICU.

Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND)

Amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) is a fatal neurological disease which produces paralysis of the limb, swallowing and breathing muscles. There is no available treatment to stop or reverse its progressive course. In this review, we examine the evidence from four randomized clinical trials involving 1477 people with ALS. The methodological quality of the trials was acceptable and three of the trials were easily comparable (although one of them included older patients with more advanced ALS). The searches for this review were last updated in 2011, when we found no new randomized controlled trials. The results indicate that riluzole 100 mg probably prolongs median survival in people with ALS by two to three months and the safety of the drug is not a major concern. The evidence from randomized controlled trials indicates that participants taking riluzole probably survive longer than participants taking placebo. The beneficial effects are very modest and the drug is expensive. There was a small beneficial effect on both bulbar and limb function, but not on muscle strength. Adverse effects from riluzole are relatively minor and for the most part reversible after stopping the drug.

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More about Tracheostomy

Photo of an adult

See Also: Tracheostomy Tube

Other terms to know:
Larynx (Voice Box), Stoma, Trachea (Windpipe)

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