TRACHEOTOMY—INDICATIONS, ADVANTAGES, TECHNIQUES, COMPLICATIONS, AND RESULTS

Abstract

• Tracheotomy is now recognized as a singularly effective means for removing retained secretions, for improving ventilation, and for obtaining physiological advantages in many different disease states, in addition to bypassing mechanical obstruction of the airway. The indications for tracheotomy can be separated into two broad categories, mechanical and secretional ventilatory. The benefits of tracheotomy in bypassing an obstruction are realized to a much greater degree if the operation is performed before severe obstruction develops. The physiological improvements following tracheotomy are improvement of ventilatory efficiency and removal of secretions, as well as assistance to the patient with a reduced vital capacity, such as in spinal cord injury, poliomyelitis, encephalitis, severe burns, and after extensive thoracic or abdominal operations.