Tracheostomy in the ICU

The placement of a tracheostomy has become a routine procedure for intensiv e care unit patients who are mechanical ventilator dependent for a period o f time, usually exceeding 1 or 2 weeks. It is vital for the intensivist to be familiar with all aspects of tracheostomies care including the timing of converting a patient to a tracheostomy, types of procedure, risks and bene fits, and issues of daily care including oral feedings, speech, and decannu lation. In this article we provide a comprehensive review for the intensivi st regarding tracheostomies in the intensive care setting. We specifically review indications, timing, surgical options including percutaneous dilatio n tracheostomy, complications, decannulation, oral feeding, speaking devise s, stomal stents, and routine tracheostomy care.