Trachéotomie et sevrage de la ventilation mécanique

Tracheotomy is commonly performed when patients are scheduled for prolonged ventilatory support or after extubation failure. Tracheotomy does not reduce mortality rate in intensive care units nor it decreases the incidence of ventilatory acquired pneumonia. Tracheotomy likely reduces duration of mechanical ventilation, spares sedation requirements and eventually improves patient's comfort. Transcutaneous tracheotomy is more and more commonly used instead of surgical tracheotomy. Tracheotomy is ideally performed within five to seven days of mechanical ventilation when long duration ventilator support is expected. In daily practice, tracheotomy remains commonly decided as the case may be.