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Management of tracheostomies in the intensive care unit: a scoping review
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  • Published on:
    Safe, patient focussed, multidisciplinary tracheostomy care should be the goal for Critical Care research teams
    • James Lynch, Advanced Critical Care Practitioner Manchester University NHS Foundation Trust
    • Other Contributors:
      • Sarah Wallace, Speech and Language Therapist
      • Barbara Bonvento, Physiotherapist
      • Brendan A McGrath, Consultant Intensivist

    Dear Editors
    We read with interest the scoping review by Whitmore and colleagues into the post-insertion and pre-decannulation management of tracheostomies in the Intensive Care Unit.1 This important work highlights the need and opportunity for research in some areas of the complex management of these vulnerable patients. However, the manuscript has some significant limitations particularly; search strategy; timing; omission of patient safety recommendations; and patient focus; which we discuss below.
    The search strategy is limited to minor variations in the keywords, “ICU”, “Intensive Care Unit” and “Tracheostomy,” which excludes any article with the US “tracheotomy” in the title and international variations in care locations, such as, “Intensive Therapy Unit”, “Critical Care Unit”, “Weaning Unit”, “High Care” and associated abbreviations. The authors themselves refer to “critical care” literature but have omitted this from their strategy. A PubMed search (www.pubmed.ncbi.nlm.nih.gov, 27/8/20) finds 11,553 results for “tracheotomy,” 15,894 results for “tracheostomy” and 25,243 results for “tracheostomy or tracheotomy”.
    Furthermore, whilst the search is necessarily time-limited, there has been a recent surge in tracheostomy literature including relevant publications for managing tracheostomy in the COVID-19 pandemic.2-4 Whilst the results from Whitmore and colleagues are a useful benchmark, we fear that the...

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    Conflict of Interest:
    None declared.