In 175 ad, Galen inflated the lungs of a dead animal with a bellows, similar to that used to keep a fire alive. This was the beginning of mechanical ventilation. Marco Aurelio Severino (1580–1656) was one of the first to use the tracheostomy as an operation for obstructed air passages. With a trocar-like instrument, he was able to save innumerable lives during the diphtheria epidemic in Naples in 1610. Lorenz Heister (1683–1758) established the term tracheotomy for a windpipe incision.1
From then on, many changes have occurred. With improvements in critical care, we now have patients receiving mechanical ventilation for years or even decades. For this reason, tracheotomies have become one of the most common surgeries performed in critically ill patients.