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Tracheostomy is a common surgical procedure, and is increasingly performed in the intensive care unit (ICU) as opposed to the operating room. Procedural knowledge is essential and is therefore outlined in this review. We also review several high-quality studies comparing percutaneous dilational tracheostomy and open surgical tracheostomy. The percutaneous method has a comparable, if not superior, safety profile and lower cost compared with the open surgical approach; therefore the percutaneous method is increasingly chosen. Studies comparing early versus late tracheostomy suggest morbidity benefits that include less nosocomial pneumonia, shorter mechanical ventilation and shorter stay in the ICU. However, we discuss the questions that remain regarding the optimal timing of tracheostomy. We outline the potential acute and chronic complications of tracheostomy and their management, and we review the different tracheostomy tubes, their indications and when to remove them. [ABSTRACT FROM AUTHOR]

The Critical Care Strategic Clinical Network (CC SCN) focuses on ensuring the highest-quality evidence-based care for people with critical illness in Alberta. Advancing implementation science in Alberta's critical care community and supporting a learning health system through collaboration: the Provincial ICU Delirium Initiative Critical Care Canada Forum [abstract].. Critical Care Forum.; 2019Nov. [Extracted from the article]