Email updates

Keep up to date with the latest news and content from Critical Care and BioMed Central.

Review

Pro/con clinical debate: Tracheostomy is ideal for withdrawal of mechanical ventilation in severe neurological impairment

Luciana Mascia1, Eleomore Corno2, Pier Paok Terragni3, David Stather4 and Niall D Ferguson5

Author Affiliations

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

For all author emails, please log on.

Critical Care 2004, 8:327-330  doi:10.1186/cc2864

Published: 13 May 2004

Abstract

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.

Keywords:
brain injury; intubation; neurosurgical intensive care; tracheostomy; weaning