Tracheostomy
Following advances in intensive care unit and widespread administration of mechanical ventilation, tracheostomy has become one of the indispensable surgical procedures.
Timing
Although early tracheostomy (ET) is recommended for patients with severe stroke, the optimal timing of tracheostomy for patients with intracerebral hemorrhage (ICH) remains controversial.
Early tracheotomy was defined as intervention no more than 7 days after initiation of mechanical ventilation. late as tracheostomy placement after 7 days or no tracheotomy.
Strategies
Surgically Created Tracheostomy (SCT)
Percutaneous Dilatational Tracheostomy (PDT).
In a randomized clinical trial, there were significant differences between two groups of patients in terms of duration of receiving mechanical ventilation (P=0.04), duration of tracheostomy procedure (P=0.001) and procedure expenses (P=0.04). There was no significant difference between two groups in terms of age and gender of patients, duration of ICU stay and complications of tracheostomy including copious bleeding, stomal infection, subcutaneous emphysema and airway.
PDT can be considered as the preferred procedure in cautiously selected patients during their ICU stay 1).