Surgical airway management in the intensive care unit

Tracheostomy is one of the most common surgical procedures performed on cri tically ill and injured patients in the United States today. Despite decade s of experience among surgeons, there is still controversy over specific in dications, techniques, and timing of performing the surgical airway New tec hniques, such as percutaneous dilatational tracheostomy and minitracheostom y, have challenged critical care physicians to tailor operative airway meth ods to each individual patient. Older procedures, such as cricrothyroidotom y, have found a new niche in the intensive care unit. These new techniques, along with new ways to perform traditional tracheostomies, have made the p ractice of operative airway management dynamic and controversial.