What is a
tracheostomy tube?
A tracheostomy tube is a small tube designed to be directly placed
into a patient's windpipe through the neck. The surgical procedure
of inserting a tracheostomy tube into a patient's windpipe is called
a tracheotomy.
When is a tracheostomy needed?
A tracheostomy tube may be needed for ICU patients requiring
long-term
mechanical ventilation, patients unable to cough effectively to
clear secretions, and patients with an obstructed or blocked
airway.
The decision to perform a tracheostomy on a particular patient
depends upon the circumstances surrounding that patient and often
follows use of breathing (endotracheal) tube.
How is a tracheostomy performed?
The tracheostomy can be performed in the operating room or at the
patient's bedside. Typically light
anesthesia is required during the tracheostomy procedure. The
tracheostomy tube can be inserted either of two ways - the open
technique or the
percutaneous technique.
The open technique involves a small
incision made in the lower part of the neck just above the
windpipe (trachea).
Subsequently, an incision is made in the windpipe (trachea) and the
tracheostomy tube is inserted.
The percutaneous technique involves the formation of a small
opening in the trachea that is gradually dilated to the size of the
tracheostomy tube.
Either technique is an acceptable approach to inserting a
tracheostomy tube in a critically ill or injured patient. After the
tracheostomy tube is secured, the patient's
breathing tube is removed.
The advantages of a tracheostomy tube over the breathing tube
are: the patient is usually more comfortable, the patient may be
able to drink or eat with the tracheostomy tube in place, and the
tracheostomy tube may make it easier for the patient to breathe.
Most tracheostomy tube insertions performed on ICU patients are
temporary. Patients may be able to speak with a tracheostomy tube in
place once they are able to breathe spontaneously (i.e., are off the
breathing machine [mechanical
ventilator]).
How long is a tracheostomy used?
Sometimes tracheostomy tubes are used only for days, weeks or even
months and then removed. Under other circumstances the tracheostomy
tube may be left in place for the rest of the patient's life.
Does a tracheostomy hurt?
Numbing medicine (local
anesthesia) or
general anesthesia is used during
tracheostomy tube placement. The procedure is usually associated
with minimal to no discomfort.
Are there any potential complications
associated with a tracheostomy?
The potential complications associated with the insertion of a
tracheostomy tube are bleeding and infection. With time,
tracheostomy tubes need to be replaced. This is accomplished by
removing the existing tracheostomy tube and replacing it with a new
tube through the existing opening in the windpipe. This is performed
with little to no discomfort to the patient.
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Tracheostomy (Tracheotomy) 
