[Tracheostomy in ventilated patients. What do we do it for?]

The tracheostomy has turned into one of the procedures most performed in the intensive care units. To this fact they have contributed the introduction of the percutaneous technique and the theoretical advantages that tracheostomy has: increase of the comfort of the patient, decrease of the dead space, improvement of the bronchial toilet and decrease in the requirement of sedation. But these advantages are not sufficient evidence for the indication of a tracheostomy. The comparative studies show that the performance of a tracheostomy, versus translaryngeal intubation, could relate to a lower mortality in the unit of intensive care, but tracheostomy does not improve other outcomes as length of stay in the unit of intensive care, length of stay in the hospital and the mortality in the hospital. More studies are needed to be able to estimate what patients would benefit from a tracheostomy and which is the optimal timing for its performance.