Explain the term Tracheostomy ?

If the duration of mechanical ventilation is likely to be prolonged, it is wise to do an early tracheostomy. Otherwise, a tracheostomy is usually done if at the end of two weeks of ventilation it looks unlikey that the patient may be extubatable within a day or two. A tracheostomy may offer the following advantages compared an endotracheal tube:

• Reduces anatomical dead space,
• Reduces resistance to breathing,
• Weaning may be quicker,
• Easier to do tracheal toilet,
• Sedation can be lightened or stopped,
• Better communication possible compared to an endotracheal tube,
• Easier to mobilize, and
• Possible to eat and drink.

In the ICU, it is generally preferable to do the tracheostomy by the bedside because transferring a sick patient to the theatre and back can be hazardous. Apart from the conventional open method, the percutaneous guidewire - dilatation method is increasingly being used in ICUs. Complications with this technique have been shown to be no more compared to the conventional method.