Skip to main content

Percutaneous Dilatational Tracheostomy, Open Surgical Tracheostomy and Management of Tracheostomy Tubes

  • Chapter
  • First Online:
Interventional Critical Care
  • 1795 Accesses

Abstract

Both open surgical tracheostomy and percutaneous dilational tracheostomy procedures are used to help facilitate critically ill and injured patients in weaning from mechanical ventilation and are sometimes used to protect an injured or diseased airway. Both open and percutaneous tracheostomy can help improve patient comfort and are safe in appropriate patients. Tracheostomy is a common procedure for critically ill and injured patients. This chapter will review these procedures and discuss the clinical implications of tracheostomy and the management of tracheostomy tubes after placement. We will discuss current recommendations for tracheostomy placement for patients infected with COVID-19.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hoffman M. Tracheostomies and PEGs: when are they really indicated? Surg Clin N Am. 2019;99(5):955–65.

    Article  Google Scholar 

  2. Lerner AD, Yarmus L. Percutaneous dilational tracheostomy. Clin Chest Med. 2018;39(1):211–22.

    Article  Google Scholar 

  3. Freeman B. Tracheostomy update: when and how. Crit Care Clin. 2017;33:311–22.

    Article  Google Scholar 

  4. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy: a new simple bedside procedure; preliminary report. Chest. 1985;87(6):715–9.

    Article  CAS  Google Scholar 

  5. Raimondi N, et al. Evidence-based guidelines for the use of tracheostomy in critically ill patients. J Crit Care. 2017;38:304–18.

    Article  Google Scholar 

  6. Kornblith LZ, et al. One thousand bedside percutaneous tracheostomies in the surgical intensive care unit: time to change the gold standard. J Am Coll Surg. 2011;212(2):163–70.

    Article  Google Scholar 

  7. Delaney A, Bagshaw SM, Nalos M. Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta- analysis. Crit Care. 2006;10(2):R55.

    Article  Google Scholar 

  8. Smith I, Fleming S, Cernaianu A. Mishaps during transport from the intensive care unit. Crit Care Med. 1990;18(3):278–81.

    Article  CAS  Google Scholar 

  9. Cobean R, et al. Percutaneous dilatational tracheostomy. A safe, cost-effective bedside procedure. Arch Surg. 1996;131(3):265–71.

    Article  CAS  Google Scholar 

  10. Grover A, et al. Open versus percutaneous dilatational tracheostomy: efficacy and cost analysis. Am Surg. 2001;67(4):297–301. discussion 301–2.

    CAS  PubMed  Google Scholar 

  11. Lui C, Rudmik A. Cost-effectiveness analysis of early vs late tracheostomy. JAMA Otolaryngol Head Neck Surg. 2016;142(10):981–7.

    Article  Google Scholar 

  12. Mirski MA, Pandian V, Bhatti N, et al. Safety, efficiency, and cost- effectiveness of a multidisciplinary percutaneous tracheostomy program. Crit Care Med. 2012;40(6):1827–34.

    Article  Google Scholar 

  13. Rumbak MJ, et al. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med. 2004;32(8):1689–94.

    Article  Google Scholar 

  14. Arabi Y, et al. Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review. Crit Care. 2004;8(5):R347–52.

    Article  Google Scholar 

  15. Zagli G, et al. Early tracheostomy in intensive care unit: a retrospective study of 506 cases of video- guided Ciaglia Blue Rhino tracheostomies. J Trauma. 2010;68(2):367–72.

    PubMed  Google Scholar 

  16. Villwock JA, Villwock MR, Deshaies EM. Tracheostomy timing affects stroke recovery. J Stroke Cerebrovasc Dis. 2014;23(5):1069–72.

    Article  Google Scholar 

  17. Alali AS, et al. Tracheostomy timing in traumatic brain injury: a propensity-matched cohort study. J Trauma Acute Care Surg. 2014;76(1):70–8.

    Article  Google Scholar 

  18. Babu R, et al. Timing of tracheostomy after anterior cervical spine fixation. J Trauma Acute Care Surg. 2013;74(4):961–6.

    Article  Google Scholar 

  19. Northrup BE, et al. Occurrence of infection in anterior cervical fusion for spinal cord injury after tracheostomy. Spine (Phila Pa 1976). 1995;20(22):2449–53.

    Article  CAS  Google Scholar 

  20. Dennis BM, et al. Safety of bedside percutaneous tracheostomy in the critically ill: evaluation of more than 3,000 procedures. J Am Coll Surg. 2013;216(4):858–65. discussion 865–7.

    Article  Google Scholar 

  21. Simon M, et al. Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors. Crit Care. 2013;17(5):R258.

    Article  Google Scholar 

  22. Mehta C, Mehta Y. Percutaneous tracheostomy. Ann Card Anesth. 2017;20(Suppl):S19–25.

    Article  Google Scholar 

  23. Mecham J, et al. Utility of tracheostomy in patients with COVID-19 and other special considerations. Laryngoscope. 2020:1:1–4.

    Google Scholar 

  24. Takhar A, et al. Recommendation of a practical guideline for safe tracheostomy during the COVID-19 pandemic. Eur Arch Otorhinolaryngol. 2020;277:2173–84.

    Article  Google Scholar 

  25. Prabhakaran K. Open tracheostomy for COVID-19-positive patients: a method to minimize aerosolization and reduce risk of exposure. J Trauma Acute Care Surg. 2020;89(2):265–71.

    Article  CAS  Google Scholar 

  26. Engels P, et al. Tracheostomy: from insertion to decannulation. Can J Surgery. 2009;52(5):427–33.

    Google Scholar 

  27. Twose P, et al. Enhancing care of patients requiring a tracheostomy: a sustained quality improvement project. J Crit Care. 2019;55:191–6.

    Article  Google Scholar 

  28. CMS. Physician fee schedule. Retrieved from: https://www.cms.gov/apps/physician-feeschedule/overview.aspx. Accessed 1 Sept 2020.

  29. Singh J, Sing R. Performance, long-term management, and coding for percutaneous dilational tracheostomy. Chest. 2019;155(3):639–44.

    Article  Google Scholar 

Additional Resources

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Scott P. Sherry .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sherry, S.P. (2021). Percutaneous Dilatational Tracheostomy, Open Surgical Tracheostomy and Management of Tracheostomy Tubes. In: Taylor, D.A., Sherry, S.P., Sing, R.F. (eds) Interventional Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-64661-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-64661-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-64660-8

  • Online ISBN: 978-3-030-64661-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics