Advantages and disadvantages of tracheostomy versus tracheal intubation

	Tracheostomy	Intubation
Advantages	Ease of replacement (once tract has formed) Speech, mobility, and swallowing enhanced Patient can be nursed outside of ICU Ease of suctioning Patient comfort Improved oral care and hygiene Airway stability during transport or ambulation	Rapid insertion by skilled consultant in most settings Lack of need for surgical procedure (risk, expense) Lack of stomal complications
Disadvantages	Complications at cuff site Stomal complications Possible contribution to ultimate laryngeal injury Tracheoinnominate artery fistula formation Mediastinitis (shortly after placement) High mortality for inadvertent decannulation before tract formation	Complications at cuff site Laryngeal complications Replacement requires skill at all times Generally requires ICU level supervision Injuries at nose or mouth Potential need for increased sedation

ICU: intensive care unit.

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