Tracheostomy: Indications, Safety and Outcomes

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Amit Agrawal, MD (Editor) – Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Series: Surgery – Procedures, Complications, and Results
BISAC: MED079000
DOI: https://doi.org/10.52305/PJKV2712

Tracheostomy is one of the simplest, most valuable operations in surgical practice. In tracheostomy an opening is made in the anterior wall of the trachea and this opening is used for insufflation of oxygen- air mixture into the lungs. A tracheostomy may be performed on an emergency or elective basis; it may be a temporary or a permanent one. Over the past several years the indications for a tracheostomy have radically evolved. Earlier tracheostomies were mostly done to relieve an upper airway obstruction; now tracheostomies are mostly done in critical care settings to facilitate mechanical ventilation. Open surgical tracheostomy (OST) is usually done in an operation theatre.

A detailed description is given in the relevant chapter of the book, but a certain salient point needs to be emphasized here. First and foremost, neck anatomy is to be clearly defined and structures should be identified, as most of the complications occur when the surgeon deviates from the midline. Percutaneous tracheostomy (PCT) has certain distinct advantages over open surgical tracheostomy (OST); PCT is faster to perform, easier to learn and can be performed at the point of care. In most adult ICU patients, a percutaneous tracheostomy (PCT) is the preferred technique unless contraindicated. Compared to surgical tracheostomy it leads to significantly lesser wound infections, but it is associated with a higher rate of accidental decannulation and obstruction. Use of real time ultrasonography while performing percutaneous tracheostomy has also helped in better identification of tracheal rings and hence in improving its safety for obese patients.

Tracheostomies are usually straightforward, but complications still occur, often due to improper technique. Complications may be due to structural damage to vital structures of the neck leading to hemorrhage, tracheal damage, esophageal damage, failure to proceed, air embolism, aspiration, hypoxemia, tube misplacement, pneumothorax, tracheal stenosis, trachea-arterial and trachea-esophageal fistula. This book encompasses many clinically relevant scenarios in which a tracheostomy may be needed. However, certain situations demand special expertise; tracheostomy in pregnancy is one such situation. The aim of this book is to apprise readers with all the practical aspects of tracheostomy from patient’s selection to tracheostomy in special situations.

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Table of Contents

Preface

Chapter 1. Tracheostomy: An Introduction
(Anuj Jain, MD, Nitish Baisakhiya and Amit Agrawal-Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India, et al.)

Chapter 2. Historical Overview of Tracheostomy
(Krishan Yadav and M. S. Sridhar-Command Hospital Air Force Bangalore, Karnataka, India)

Chapter 3. Surgical Anatomy of Trachea
(K. L. Sampath Kumar-Department of Surgery, Narayana Medical College, Nellore (AP), India)

Chapter 4. Tracheostomy: Indication, Safety, and Outcomes
(Ravisankar Manogaran, Ved Prakash Maurya, Arulalan Mathialagan, Bhawan Nangarwal and Sanjay Behari-Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India)

Chapter 5. Indications and Contraindications of Tracheostomy
(Venkat Rajasurya, MD and Salim Surani, MD-Multicare Health System Puyallup, Washington, USA, et al.)

Chapter 6. Pre-Tracheostomy Investigations
(Ivan David Lozada-Martínez, Laura Marcela Acevedo-Aguilar and Irina González-Gómez-Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia, et al.)

Chapter 7. Tracheostomy: The Role of Imaging
(Manchikanti Venkatesh-Department of Radio-Diagnosis, Narayana medical College, Nellore, Andhra Pradesh, India)

Chapter 8. Timing of Tracheostomy
(Tariq Janjua-Regions Hospital, Saint Paul, MN USA)

Chapter 9. Tracheostomy: Conventional Technique
(José de Jesús Bohórquez-Rivero, MD and Luis Rafaél Moscote Salazar-Faculty of Medicine, University of Sinú, Cartagena, Colombia, et al.)

Chapter 10. Difficult Tracheostomy: Techniques and Concepts
(M. S. Sridhar, Krishan K. Yadav, Pankaj Sahu and Parli R. Ravi- Department of Neurosciences, Command Hospital Air Force Bangalore, India)

Chapter 11. Tracheostomy in Pregnancy
(Ajay Haldar, MD and Pankhuri Dubey, MD-All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India)

Chapter 12. Mediastinal Tracheostomy
(Md. Moshiur Rahman, SM Khorshed Mazumder and Sabrina Rahman- Neurosurgery Department, Holy Family Red Crescent Medical College, Dhaka, Bangladesh, et al.)

Chapter 13. Complications of Tracheostomy
(Venkat Rajasurya, MD and Salim Surani, MD-Multicare Health System Puyallup, Washington, USA, et al.)

Chapter 14. Tracheal Stenosis
(Sabharisan Paramasivam, Lokesh Kumar and Shashikant Anil Pol-Department of ENT-HNS, JIPMER, Puducherry, India, et al.)

Chapter-15. Tracheostomy Care
(Sulakshana Sulakshana and B. Kishansing Naik-Department of Critical Care, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India)

Chapter 16. Post-Tracheostomy Rehabilitation
(Sulakshana Sulakshana and B. Kishansing Naik-Department of Critical Care, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India)

Chapter 17. Tracheostomy Decannulation
(Jitin Bajaj and YR Yadav-Department of Neurosurgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, India)

Chapter 18. Tracheostomy and Nutrition
(William Camargo-Martínez, Ivan Lozada-Martínez and William Llamas-Bustos-Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia, et al.)

Chapter 19. Tracheostomy in Neurosurgery Patients
(Ravi Dadlani-Department of Neurosurgery, Zulekha Hospital, Sharjah, UAE)

Chapter 20. Pediatric Tracheostomy
(Shashikant Anil Pol, Lokesh Kumar, Sabarisan Paramasivam and Praveen Basker-Department of ENT-HNS, AIIMS Bilaspur, Himachal Pradesh, India, et al.)

Chapter 21. Tracheostomy in Patients with Malignant Lesions
(Orlin Pavlov-Department of Neurosurgery, University Medicine Marburg, Marburg, Hesse, Germany, Klinikum Fulda, Fulda, Germany)

Chapter 22. Tracheostomy in War and Conflict Zones
(Shashivadhanan Sundaravadhanan and Praveen Kumar Yadav-Military Hospital Bathinda, Punjab, India)

Index

 

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