Anestéziológia a intenzívna medicína 2/2024
Tracheostomy in the hands of an intensivist
In recent years, tracheostomy in intensive care medicine has come fully within the competence of the intensivist physician, not only because he decides on its indication, but also by expanding the so-called bedside methods. This, in the form of puncture dilatation tracheostomy, can be performed at the patient‘s bedside in a short time and in the hands of an experienced doctor with a minimum of complications. This relatively frequent procedure allows us to completely reduce or stop sedation and thus facilitate weaning of the patient, i.e. disconnecting him from artificial pulmonary ventilation, which is of fundamental importance in elderly patients with minimal reserves. Despite the clear motivation and goals, neither the indications for tracheostomy nor its timing are clear to this day. The question remains whether early tracheostomy has an impact on the patient‘s outcome not only from the point of view of leaving the intensive care unit, but also improving the quality of life and returning to society.
Keywords: punctional dilatational tracheostomy, critically ill patient, mechanical ventilation, VAP
