Tracheostomy management in the chronically ventilated patient

Successful management of patients who require long-term ventilatory support requires a skilled approach to airway care. Tracheostomy provides multiple benefits to patient care in addition to provision of airway access for mechanical ventilation. Realization of these benefits, however, depends on knowledge of approaches for promoting speech and nutrition in the intubated patient, providing expert respiratory care, and initiating effective weaning and airway decannulation efforts.