0
Editorials |

Tracheostomy for Respiratory Failure : We Need More Answers

Marin H. Kollef
Author and Funding Information

Affiliations: St. Louis, MO
 ,  Dr. Kollef is Associate Professor of Medicine, Pulmonary and Critical Care Division, Washington University School of Medicine, and Medical Critical Care Director, Respiratory Care Services, Barnes-Jewish Hospital.

Correspondence to: Marin H. Kollef, MD, FCCP, Washington University School of Medicine, Box 8052, 660 South Euclid Ave, St. Louis, MO 63110; e-mail: kollefm@msnotes.wustl.edu



Chest. 2004;125(1):7-9. doi:10.1378/chest.125.1.7
Text Size: A A A
Published online

Extract

Tracheostomy formation is one of the most commonly performed surgical procedures in the critically ill patient who requires prolonged mechanical ventilation.12 Relative to translaryngeal intubation, tracheostomy potentially affords greater patient comfort, more effective pulmonary toilet, increased airway security, and less airway resistance.35 The latter may be especially important in patients experiencing unrecognized narrowing of their endotracheal tube lumens due to the adherence of airway secretions.6 Among patients with appropriate anatomy, tracheostomy can be safely performed at the bedside using a percutaneous technique.78 Despite the common use of tracheostomy for patients requiring prolonged mechanical ventilation, there are still several fundamental unanswered questions concerning this procedure. These questions include the following: (1) Which patients with acute respiratory failure should have a tracheostomy? (2) When during the course of mechanical ventilation should a tracheostomy be performed? (3) What are the benefits in terms of patient outcomes associated with tracheostomy?910

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543