tracheostomi

Tracheostomy is a surgical procedure in which an opening is created through the neck into the trachea to establish a secure airway. The opening is maintained with a tracheostomy tube, which can be cuffed to protect the airway and allow ventilation, or fenestrated to enable airflow to the vocal cords for speech. There are two main techniques: surgical tracheostomy performed in an operating room, and percutaneous dilational tracheostomy performed at the bedside in intensive care units.

Indications include prolonged mechanical ventilation, upper airway obstruction from trauma, tumors, or infection, and impaired airway protection in patients with reduced consciousness or neuromuscular disorders. Tracheostomy may shorten ventilator time, improve patient comfort, and reduce the risk of long-term throat injury compared with extended endotracheal intubation.

Postoperative care is essential and includes securing the tube, monitoring cuff pressure, humidified air, suctioning, and routine oral and tracheal hygiene. Complications can be immediate (bleeding, pneumothorax, tube misplacement) or delayed (tube obstruction, decannulation, infection, tracheal stenosis, fistula formation).

Decannulation is considered when the patient can breathe adequately through the upper airway, cough effectively, and manage secretions. Tracheostomy is a common, life-saving intervention in critical care, and ongoing care involves multidisciplinary teams to manage airway, nutrition, infection risk, and communication needs.