• Kamran Mahmood and Momen M Wahidi.
• Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Duke University Medical Center, DUMC 102356, Durham, NC 27710, USA. Electronic address: k.mahmood@duke.edu.
• Clin. Chest Med. 2016 Dec 1; 37 (4): 741-751.

AbstractTracheostomy is performed in patients who require prolonged mechanical ventilation or have upper airway instability. Percutaneous tracheostomy with Ciaglia technique is commonly used and rivals the surgical approach. Percutaneous technique is associated with decreased risk of stomal inflammation, infection, and bleeding along with reduction in health resource utilization when performed at bedside. Bronchoscopy and ultrasound guidance improve the safety of percutaneous tracheostomy. Early tracheostomy decreases the need for sedation and intensive care unit stay but may be unnecessary in some patients who can be extubated later successfully. A multidisciplinary approach to tracheostomy care leads to improved outcomes.Copyright © 2016 Elsevier Inc. All rights reserved.

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