Shirawi Nehad, Arabi Yaseen
Intensive Care Department, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
Crit Care. 2006 Feb;10(1):201. doi: 10.1186/cc3828.
A significant proportion of trauma patients require tracheostomy during intensive care unit stay. The timing of this procedure remains a subject of debate. The decision for tracheostomy should take into consideration the risks and benefits of prolonged endotracheal intubation versus tracheostomy. Timing of tracheostomy is also influenced by the indications for the procedure, which include relief of upper airway obstruction, airway access in patients with cervical spine injury, management of retained airway secretions, maintenance of patent airway and airway access for prolonged mechanical ventilation. This review summarizes the potential advantages of tracheostomy versus endotracheal intubation, the different indications for tracheostomy in trauma patients and studies examining early versus late tracheostomy. It also reviews the predictors of prolonged mechanical ventilation, which may guide the decision regarding the timing of tracheostomy.
相当一部分创伤患者在重症监护病房住院期间需要进行气管切开术。该手术的时机仍是一个有争议的话题。气管切开术的决策应考虑长期气管插管与气管切开术的风险和益处。气管切开术的时机还受该手术适应证的影响，这些适应证包括缓解上呼吸道梗阻、颈椎损伤患者的气道通路建立、气道分泌物潴留的处理、维持气道通畅以及为长期机械通气建立气道通路。本综述总结了气管切开术与气管插管相比的潜在优势、创伤患者气管切开术的不同适应证以及早期与晚期气管切开术的相关研究。它还回顾了长期机械通气的预测因素，这些因素可能有助于指导气管切开术时机的决策。
