[Innovations and new techniques: tracheostomy cannulas]

In recent years, therapy by means of a tracheostomy has increased considerably due to the use of new trachea opening procedures and the development of the newest generation of tubes employed in tracheostomy. Percutaneous tracheostomy has become the preferred choice technique for patients in critical condition since it is a simple procedure, almost bloodless, and furthermore, this procedure can be carried out on a patient in a bed in a normal ward. The translaryngeal tracheostomy is one of the newest innovative techniques performed from inside the trachea; due to its complex nature, it is not commonly used yet although it promises to be an alternative procedure when confronting various counter-indications found in the percutaneous technique. In addition to the development of these techniques, substantial design modifications in the tubes used in tracheostomy have been produced; their objectives include improving a patient's comfortableness, reducing complications and easing a nurse's work.