Pro/con clinical debate: Tracheostomy is ideal for withdrawal of mechanical ventilation in severe neurological impairment
1 Assistant Professor, Dipartimento di Discipline Medico Chirurgiche, Sezione di Anestesiologia e Rianimazione, University of Turin, Turin, Italy
2 Resident, Dipartimento di Discipline Medico Chirurgiche, Sezione di Anestesiologia e Rianimazione, University of Turin, Turin, Italy
3 Staff Physician, Dipartimento di Discipline Medico Chirurgiche, Sezione di Anestesiologia e Rianimazione, University of Turin, Turin, Italy
4 Fellow, Respirology and Critical Care Medicine, University of Toronto, Toronto, Canada
5 Assistant Professor, Department of Medicine, Division of Respirology, and the Interdepartmental Division of Critical Care Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Canada
Critical Care 2004, 8:327-330 doi:10.1186/cc2864
Published: 13 May 2004Abstract
Most clinical trials on the topic of extubation have involved patients outside the neurological intensive care unit. As a result, in this area clinicians are left with little evidence on which to base their decision making. Although tracheostomies are increasingly common procedures, they are not without complications and costs, and hence a decision to perform them should not be taken lightly. In this issue of Critical Care two groups debate the merits of tracheostomy before extubation in a patient with neurological impairment. What becomes very clear is the need for more high quality data for this common clinical problem.
