Tracheostomy – a multiprofessional handbook

Tracheostomy is one of the most frequent procedures performed on critically ill patients. It has advantages compared with translaryngeal endotracheal intubation, such as reduced laryngeal anatomical alterations, reduced inspiratory load, better tolerance by the patient and better nursing. Thus, tracheostomy can ease a patient's care in the event of prolonged respiratory support and difficult weaning, for different categories of patients. Different targets need to be addressed for tracheostomy: first, the patient's selection; second, the optimal timing; third, the tracheostomy technique to be used in relation to the anatomical and clinical characteristics of the patient; fourth, and most importantly, the overall clinical management of the tracheostomy and the patient as an individual have to be carefully considered. In this respect, the authors of this book have to be congratulated because they have focused not only on specific technical problems related to the daily management of tracheostomy but also on the patient's general clinical management including infective and nutritional aspects. For this purpose the editors brought together a balanced team clinically active in the field to provide a comprehensive review of tracheostomy-related problems. A multidisciplinary team approach can improve the care of patients with tracheostomies. These dedicated teams, composed of doctors, nurses, speech therapists, physiotherapists and dietetic staff, daily have to work closely and in a coordinated manner to ensure all the needs of these patients to improve their clinical and psychological outcome. We believe that this is the most important message from this book, emphasizing the crucial role of each specialist to determine the appropriate achievement of the targets when tracheostomy has to be performed. It is a 392-page paperback book with 22 chapters covering the following topics: first, the upper airway and respiratory basic anatomy; second, the technical basis of tracheostomy and how it alters the upper airway's anatomy; third, the description of different tracheostomy tubes and surgical or percutaneous tracheostomy approaches; fourth, the medical and nursing care of tracheostomy in the early phase after the operation and in the long term, including humidification, suctioning, wound care, swallowing and communication; fifth, the problems related to changing the tracheostomy tube and decannulation; sixth, particular attention to the technical and practical problems of tracheostomy of children; seventh, infection management and nutritional care of the tracheostomized patient. Particularly important are the sections dedicated to tracheostomy problems in children. Tracheostomy in children is not as common as in adults, but when it occurs both …