To trach or not to trach, that is the question

摘要: Progressive neuromuscular disease requires increasing degrees of respiratory support to sustain life. Each step from intermittent continuous-and noninvasive invasive-ventilation thoughtful consideration based on the goals patient and family, inherent benefits burdens treatment. Tracheostomy, in particular, should not be viewed as an inevitable next when less permanent or invasive methods prove insufficient. Like other modes support, tracheostomy may represent a bridge recovery pulmonary function, stabilizing action hope that novel therapies beneficial. In situations, represents destination therapy, necessitating implications chronic mechanical ventilation. Institutional, social, financial considerations affect decisions related tracheostomy, implicit bias regarding quality The complexity such care highlight need for optimal palliative throughout patient's