TY - JOUR
T1 - Tracheotomy in the intensive care unit
T2 - Guidelines from a French expert panel: The French Intensive Care Society and the French Society of Anaesthesia and Intensive Care Medicine
AU - For the French Intensive Care Society
AU - For the French Society of Anaesthesia and Intensive Care
AU - Trouillet, Jean Louis
AU - Collange, Olivier
AU - Belafia, Fouad
AU - Blot, François
AU - Capellier, Gilles
AU - Cesareo, Eric
AU - Constantin, Jean Michel
AU - Demoule, Alexandre
AU - Diehl, Jean Luc
AU - Guinot, Pierre Grégoire
AU - Jegoux, Franck
AU - L'Her, Erwan
AU - Luyt, Charles Edouard
AU - Mahjoub, Yazine
AU - Mayaux, Julien
AU - Quintard, Hervé
AU - Ravat, François
AU - Vergez, Sébastien
AU - Amour, Julien
AU - Guillot, Max
AU - Quillot, Max
AU - Collange, Olivier
N1 - Publisher Copyright:
© 2018 The Author(s)
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de réanimation de langue française) and the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie réanimation) with the participation of the French Emergency Medicine Association (Société française de médecine d'urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1 ±) and 6 a low level of proof (Grade 2 ±). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced.
AB - Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Société de réanimation de langue française) and the French Society of Anesthesia and Intensive Care Medicine (Société francaise d'anesthésie réanimation) with the participation of the French Emergency Medicine Association (Société française de médecine d'urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1 ±) and 6 a low level of proof (Grade 2 ±). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced.
UR - http://www.scopus.com/inward/record.url?scp=85044021901&partnerID=8YFLogxK
U2 - 10.1016/j.accpm.2018.02.012
DO - 10.1016/j.accpm.2018.02.012
M3 - Article
C2 - 29559211
AN - SCOPUS:85044021901
SN - 2352-5568
VL - 37
SP - 281
EP - 294
JO - Anaesthesia Critical Care and Pain Medicine
JF - Anaesthesia Critical Care and Pain Medicine
IS - 3
ER -