The widening application of tracheostomy to all types of respiratory distress has been the subject of a considerable body of medical literature in the last 20 years. The classic use of tracheostomy for bypassing a high mechanical obstruction dates from the beginning of medical history and remained its prime indication until the early 1940's. Indeed, FitzHugh5 in 1941 reviewed the subject, and in 100 patients, high obstruction was the indication for the tracheostomy in every instance. Fourteen years later the same author6 was able to report that only one half of 150 tracheostomies were done for mechanical obstruction of the airway, the other one half were done for other reasons.
The use of tracheostomy for relief of retained secretions was initiated by Galloway7 in 1943 in patients with bulbar poliomyelitis. This indication was further extended by Carter and Giuseffi4 in patients with crushed chest injury, and