ReviewSeminars in respiratory and critical care medicine2015
To Trach or Not to Trach: Uncertainty in the Care of the Chronically Critically Ill.
Review in Seminars in respiratory and critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Tracheostomy outcomes in coronavirus disease 2019: a systematic review and meta-analysis.Anaesthesiology intensive therapy · 2021Pooled it
- Tracheostomy and Ventilator-Associated Pneumonia in Mechanically Ventilated ICU Patients: A Retrospective Matched Cohort Study.Journal of clinical medicine · 2026Article
- Tracheostomy in children: a narrative review.Frontiers in surgery · 2026Review
- Tracheostomy Outcomes in Children With Bronchopulmonary Dysplasia.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Outcome Predictions at Two Time Points among Surrogates and Physicians of Mechanically Ventilated Patients.Critical care explorations · 2025Article
- Assessing the role of tracheostomy placement in bronchopulmonary dysplasia with pulmonary hypertension.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- A Tracheostomy Support Device to Reduce Tracheostomy-Related Pressure Injury.Respiratory care · 2024Article
- Tracheostomy in high-risk patients on ECMO: A bedside hybrid dilational technique utilizing a Rummel tourniquet.Surgery open science · 2023Article
- COVID-19 Tracheostomy Outcomes.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2022Article
- Mortality Risk Factors in Patients Admitted with the Primary Diagnosis of Tracheostomy Complications: An Analysis of 8026 Patients.International journal of environmental research and public health · 2022Article
- Deep learning to predict long-term mortality in patients requiring 7 days of mechanical ventilation.PloS one · 2021Article
- Observational
- Differences in Predictions for Survival and Expectations for Goals of Care between Physicians and Family Surrogate Decision Makers of Chronically Critically Ill Adults.Research & reviews. Journal of nursing and health sciences · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
The number of chronically critically ill patients requiring prolonged mechanical ventilation and receiving a tracheostomy is steadily increasing. Early tracheostomy in patients requiring prolonged mechanical ventilation has been proposed to decrease duration of mechanical ventilation and intensive care unit stay, reduce mortality, and improve patient comfort. However, these benefits have been difficult to demonstrate in clinical trials. So how does one determine the appropriate timing for tracheostomy placement in your patient? Here we review the potential benefits and consequences of tracheostomy, the available evidence for tracheostomy timing, communication surrounding the tracheostomy decision, and a patient-centered approach to tracheostomy. Patients requiring > 10 days of mechanical ventilation who are expected to survive their hospitalization likely benefit from tracheostomy, but protocols involving routine early tracheostomy placement do not improve patient outcomes. However, patients with neurologic injury, provided they have a good prognosis for meaningful recovery, may benefit from early tracheostomy. In chronically critically ill patients with poor prognosis, tracheostomy is unlikely to provide benefit and should only be pursued if it is consistent with the patient's values, goals, and preferences. In this setting, communication with patients and surrogates regarding tracheostomy and prognosis becomes paramount. For the foreseeable future, decisions surrounding tracheostomy will remain relevant and challenging.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.