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Article Dans Une Revue Anesthésie & Réanimation Année : 2018

Tracheotomy in ICU

1 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
2 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
3 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
4 Département de médecine oncologique [Gustave Roussy]
5 Réanimation Médicale CHRU Besançon
6 PCVP / CARDIO - Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920)
7 GReD - Génétique, Reproduction et Développement
8 CHU Pitié-Salpêtrière [AP-HP]
9 IThEM - U1140 - Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis
10 Service de Pneumologie et Soins Intensifs [CHU HEGHP]
11 Service d'anesthésie - réanimation chirurgicale [CHU de Dijon]
12 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
13 BREST - Réa Med - Service de Réanimation Médicale
14 Service de dermatologie [CHU d'Amiens-Picardie]
15 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
16 IPMC - Institut de pharmacologie moléculaire et cellulaire
17 IMFT - Institut de mécanique des fluides de Toulouse
18 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
19 Service d’Hépatogastroentérologie, NHC, CHU de Strasbourg
20 HUS - Les Hôpitaux Universitaires de Strasbourg
21 Hôpital de Hautepierre [Strasbourg]
Eric Cesareo
  • Fonction : Auteur
Francois Ravat
  • Fonction : Auteur

Résumé

Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. These guidelines were conducted by a group of experts from the French Intensive Care Society (Societe de reanimation de langue francaise) and the French Society of Anesthesia and Intensive Care Medicine (Societe francaise d'anesthesie reanimation) with the participation of the French Emergency Medicine Association (Societe francaise de medecine d'urgence), the French Society of Otorhinolaryngology. Sixteen experts and two coordinators agreed to consider questions concerning tracheotomy and its practical implementation. Five topics were defined: indications and contraindications for tracheotomy in intensive care, tracheotomy techniques in intensive care, modalities of tracheotomy in intensive care, management of patients undergoing tracheotomy in intensive care, and decannulation in intensive care. The summary made by the experts and the application of GRADE methodology led to the drawing up of 8 formal guidelines, 10 recommendations, and 3 treatment protocols. Among the 8 formal guidelines, 2 have a high level of proof (Grade 1+/-) and 6 a low level of proof (Grade 2+/-). For the 10 recommendations, GRADE methodology was not applicable and instead 10 expert opinions were produced.

Dates et versions

hal-03575442 , version 1 (15-02-2022)

Identifiants

Citer

Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, Francois Blot, Gilles Capellier, et al.. Tracheotomy in ICU. Anesthésie & Réanimation, 2018, 4 (6), pp.508-522. ⟨10.1016/j.anrea.2018.08.003⟩. ⟨hal-03575442⟩
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