The ability to guarantee adequate and quick access to the airway in lifethreatening
situations poses a challenge for clinicians who attend critically ill patients.
Surgical or percutaneous techniques have an important role in stabilizing patients in
such emergency scenarios. Patients who need prolonged mechanical ventilation may
benefit from a tracheostomy to avoid complications related to the orotracheal tube. In
these cases, tracheostomy must be achieved in the safest conditions to minimize risks
for patients. As an alternative to surgical techniques, the use and indications of
percutaneous management of the airway are rapidly increasing.
In this chapter, percutaneous management of the airway is described. The authors try to
clarify the indications and contraindications of this approach and to answer multiple
clinical questions, such as is percutaneous tracheostomy better than the surgical
approach? Which percutaneous modality is the best? When is the best moment to
perform percutaneous tracheostomy in a critically ill patient? Is there any way to
reduce complications related to percutaneous techniques?
Keywords: Blue Rhino, Blue dolphin, Cricothyrotomy, Ciaglia, Critical Care,
Emergent airway management, Fantoni, Griggs, Intensive Care Unit, Mechanical
ventilation, Prolonged ventilation, Percutaneous airway management,
Percutaneous tracheostomy, Percutwist, Surgical tracheostomy, Weaning.
