Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Tracheostomy and weaning.

David J Pierson1

  • 1Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359762, Seattle WA 98104, USA. djp@u.washington.edu

Respiratory Care
|April 6, 2005
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Thomas L Petty's lessons for the respiratory care clinician of today.

Respiratory care·2014
Same author

Oxygen in respiratory care: a personal perspective from 40 years in the field.

Respiratory care·2012
Same author

Tuberculous pleural effusion.

Respiratory care·2012
Same author

Obesity and COPD: associated symptoms, health-related quality of life, and medication use.

COPD·2011
Same author

Patient-ventilator interaction.

Respiratory care·2011
Same author

Impact of offering continuing respiratory care education credit hours on staff participation in a respiratory care journal club.

Respiratory care·2011
Same journal

Inspiratory Effort Assessment Using the Occlusion Pressure-Derived Tension-Time Index.

Respiratory care·2026
Same journal

Clinical Usage of High-Flow Nasal Cannula Across Disease Categories and Care Settings: A Nationwide Cohort Study in Japan.

Respiratory care·2026
Same journal

Efficacy of Mechanical Insufflation-Exsufflation Devices as Analyzed in Lung Models: Systematic Review and Network Meta-Analysis of Peak Expiratory Flow Data.

Respiratory care·2026
Same journal

Overnight Oxygenation and Patient Comfort Using a New Nasal Cannula Versus Standard Cannula in Long-Term Oxygen Therapy.

Respiratory care·2026
Same journal

Effects of Resting Posture on End-Expiratory Lung Impedance and Regional Ventilation Distribution, Assessed Using Electrical Impedance Tomography.

Respiratory care·2026
Same journal

Carbon Dioxide During First-Intention High-Frequency Jet Ventilation: A Narrow Therapeutic Window.

Respiratory care·2026
See all related articles

Early tracheostomy may speed up ventilator weaning and reduce intensive care unit stays and mortality. However, its benefits might stem more from influencing clinician behavior than direct physiological effects.

Area of Science:

  • Critical Care Medicine
  • Respiratory Therapy
  • Surgical Procedures

Background:

  • The belief that tracheostomy accelerates ventilator weaning is widely held but difficult to study objectively.
  • Potential benefits include reduced dead space, improved airway resistance, enhanced secretion clearance, and decreased sedation/aspiration risks.

Purpose of the Study:

  • To evaluate the impact of tracheostomy timing on ventilator weaning and patient outcomes in the intensive care unit.
  • To explore the physiological and behavioral factors influencing tracheostomy's role in weaning.

Main Methods:

  • Review of existing literature, including laboratory experiments, short-term physiologic studies, and clinical trials.
  • Analysis of data from a large multicenter trial and a recent clinical trial comparing early vs. late tracheostomy.

Related Experiment Videos

Main Results:

  • Early percutaneous dilational tracheotomy (within 2 days) significantly reduced ventilator/ICU days, pneumonia incidence, and mortality compared to tracheostomy after day 14.
  • Physiological benefits like reduced dead space are observed, but their clinical significance for weaning is uncertain.
  • One trial showed no advantage for early tracheostomy, highlighting clinician bias challenges.

Conclusions:

  • Early tracheostomy, particularly percutaneous dilational tracheotomy, appears beneficial for prolonged mechanical ventilation, reducing resource use and mortality.
  • Tracheostomy's positive impact on weaning may be partly due to influencing clinician behavior and management decisions.
  • Further research is needed to fully elucidate the complex interplay of physiological effects and clinical practice in tracheostomy-assisted weaning.