@article{article_1699258, title={Current Management of Tracheostomy in İntensive Care: Percutaneous Dilatational Techniques, Clinical Outcomes and Future Perspectives}, journal={Journal of Medical Topics and Updates}, volume={4}, pages={47–53}, year={2025}, author={Bektaş, Muammer Hayri and Kabahasanoğlu, Kadir}, keywords={Trakeotomi, Trakeostomi, Perkütan Dilatasyonel Trakeostomi, Yoğun Bakım, Mekanik Ventilasyon}, abstract={Objective: Tracheostomy is a widely utilized procedure in intensive care units (ICUs) to establish a secure long-term airway for patients requiring extended mechanical ventilation or those with upper airway obstruction. Historically, airway access was dominated by surgical tracheostomy techniques, but practice has shifted toward percutaneous dilatational tracheostomy (PDT) due to its minimally invasive approach, reduced complication rates, and the convenience of bedside performance.
Materials and Methods: This review covers tracheostomy terminology and historical evolution, and examines current literature on indications, contraindications, technical approaches, and complication management in the ICU setting.
Results: Performing a tracheostomy early (within 7–10 days of intubation) can significantly reduce ventilator-associated pneumonia (VAP) risk and shorten ICU length of stay. However, decisions must be individualized based on each patient’s clinical circumstances. Adjunctive use of ultrasound and bronchoscopy improves the safety and precision of PDT, and diligent post-procedure care is essential to prevent complications such as tracheal stenosis, infection, and tracheoesophageal fistula.
Conclusions: The field of tracheostomy management is on the verge of transformation through emerging technologies. Innovations such as robotic-assisted techniques, high-resolution imaging guidance, custom-designed patient-specific 3D-printed tracheostomy tubes, and telemedicine follow-ups promise to enhance the safety, effectiveness, and accessibility of tracheostomy care, ultimately improving patient outcomes.}, number={2}, publisher={Malatya Turgut Özal Üniversitesi}