Braune S, Kluge S
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany.
Med Klin Intensivmed Notfmed. 2012 Oct;107(7):543-7. doi: 10.1007/s00063-012-0089-y. Epub 2012 Sep 27.
Tracheotomy in mechanically ventilated critically ill patients is a procedure commonly performed in the intensive care unit. The aim is to facilitate respiratory weaning and improve clinical outcome by reducing side effects of prolonged invasive mechanical ventilation and sedation. At the same time, the risk of tracheotomy associated complications must be minimized. Indications, method and timing must be individualized for each patient. Main determinants for decision-making, success and safety are the expected individual clinical benefits, the patient risk factors for complications and aspects of local experience and logistics. This review summarizes current concepts and evidence.
在机械通气的危重症患者中行气管切开术是重症监护病房中常见的操作。其目的是通过减少长时间有创机械通气和镇静的副作用来促进呼吸脱机并改善临床结局。同时，必须将气管切开术相关并发症的风险降至最低。适应症、方法和时机必须针对每位患者进行个体化。决策、成功和安全的主要决定因素是预期的个体临床益处、患者的并发症风险因素以及当地经验和后勤保障等方面。本综述总结了当前的概念和证据。
