What is the role of tracheostomy in the treatment of smoke inhalation injury?

Updated: Oct 15, 2021
  • Author: Keith A Lafferty, MD; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

The timing of tracheostomy continues to be controversial. [58] Certainly, tracheostomy can be lifesaving for patients in whom endotracheal intubation is not possible, because of severe airway edema or burns. With early recognition of upper airway injury, this should be a rare occurrence.

Tracheostomy, especially through burned tissue, has an increased complication rate and risk of sepsis when compared with endotracheal intubation. Thus, most patients can be effectively managed with endotracheal intubation through the mouth or nose. In patients expected to have a long period of convalescence because of severe neurologic or pulmonary injury, however, tracheostomy may be desirable for patient comfort and is easy to maintain.


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