Tracheostomy

4. Advantages of tracheostomy

1. The procedure permanently secures the airway.


2. The anatomical dead space is reduced.


3. Tracheostomy byepasses the upper airway and hence it is useful in upper airway obstructions.


4. Suction can be applied through the tracheostome and bronchial secretions can hence be cleared.


5. If portex tube is used as tracheostomy tube it can be connected to a ventilator thus assisting the process of ventilation. The silastic tracheostomy tubes should not be sterilised using ethylene oxide because it has the ability to retain some to the gas for a period up to one week. The slow liberation of toxic bye products such as ethylene glycol and ethylene chlorhydrin can cause severe mucosal damage. These tubes have reduced the frequency of tracheostomy tube changes.

6. Nebulized medications (sprays, mists) and Oxygen can be effectively delivered through the tracheostome

7. Can be resorted to if long term ventilation of a patient is desired.  Long term ventilation on an intubated patient can cause subglottic stenosis.  This could be due to the irritation caused by the endotracheal tube to the mucosa lining the cricoid cartilage.  The vibrations of the ventilator could be transmitted by the endotracheal tube causing further mucosal trauma in the subglottic region.

8. Use of cuffed tracheostomy tubes helps in preventing aspiration because it effectively seals the air way from pharyngeal contents