Tracheotomy as a life-saving procedure - overview of the current knowledge

Abstract

Tracheotomy as a life-saving procedure has been known for many thousands of years. Tracheotomy remains one of the most frequently performed surgical procedures in the course of acute respiratory failure. Tracheostomy is traditionally performed as an open surgical procedure, performed both in the operating room and at the patient's bedside. Before performing the procedure, the thyroid cartilage and soft tissues are palpated. Before the operation, the patient lies on his back with a roller placed under the shoulder blades and his head tilted back. Direct and indirect laryngotracheoscopy is performed, and in doubtful situations we use computed tomography.General indications for tracheostomy are acute respiratory failure with anticipated need for prolonged mechanical ventilation and inability to wean off from mechanical ventilation, upper airway obstruction, and profuse secretions. Tracheostomy may have a beneficial effect on refractory obstructive sleep apnea. The percentage of late complications after the procedure reaches even 65%. The aim of the article is to present information on tracheostomy: its techniques, indications, contraindications, possible complications and decannulation of the patient.