The decision when to recommend tracheostomy ventilation in motor neuron disease (amyotrophic lateral sclerosis) has always been difficult. At one extreme is the view that when spontaneous ventilation or non-invasive ventilation is inadequate, a tracheostomy will save the patient’s life and lead to prolonged survival. This view has been more widely held in the USA than elsewhere. In the UK, a co...

BACKGROUND Multidisciplinary tracheostomy teams have been successful in improving operative outcomes; however, limited data exist on their effect on postoperative care. We aimed to determine the effectiveness of a multidisciplinary tracheostomy service alone and following implementation of a post-tracheostomy care bundle on rates of decannulation and tolerance of oral diet before discharge. M...

Tracheostomy is a routinely done procedure in the setting of intensive care unit (ICU) in patients requiring prolonged mechanical ventilation. There are two ways of making a tracheostomy: an open surgical tracheostomy and percutaneous dilatational tracheostomy. Percutaneous dilatational tracheostomy is associated with fewer complications than open tracheostomy. In this study, we would like to c...

Tracheo-innominate artery fistula (TIF) is known as a fatal complication after tracheostomy. We report a 9-year-old girl with early hypoxic encephalopathy who had a tracheo-innominate artery fistula with exsanguinating hemorrhage from her tracheostoma 10 months after tracheostomy. After temporary control of bleeding, embolization of the innominate artery was performed. The patient has remained ...

Tracheostomy is a well-established, commonly used surgical procedure, whose early and late complications are widely described in literature. Some of them remain still poorly known, though. One of these rare complications is a peculiar larynx-shaped reorganization of the tracheal rings and cricoid cartilage. This tracheal narrowing seems to be nonsymptomatic and not life-threatening, at least as...

STUDY OBJECTIVES To determine the patency of standard and modified Portex tracheostomy tubes inserted by the percutaneous dilatational technique. DESIGN Prospective observational study. SETTING Medical-surgical ICUs in a tertiary care community hospital. PATIENTS Medical-surgical ICU patients requiring tracheostomy. INTERVENTIONS Consecutive medical-surgical ICU patients requiring trach...