Key Points

• Both the open and percutaneous surgical techniques permit safe performance of tracheostomy. A low complication rate depends on close attention to surgical detail and adherence to existing protocols for tracheostomy care to limit the tracheal injury caused by tracheostomy tubes.
• The available evidence suggests that early tracheostomy (within 7 days after intubation) for mechanical ventilation lowers the risk of laryngeal injury and is associated with a shorter duration of mechanical ventilation and a reduced length of stay in an intensive care unit.