Part 1 Evolution of tracheostomy.- Tracheostomy from surgical to percutaneous techniques.- Anatomical and sonographic landmark.- Indication and timing.- Surgical tracheostomy.- Part 2 Percutaneous tracheostomy.- Ciaglia, multiple step dilation and single step dilation.- Ciaglia, pneumatic dilation.- Griggs dilating forceps.- Frova, rotational technique and Fantoni translaryngeal tracheostomy.- Choice of appropriate tracheostomy.- Complication of percutaneous and surgical tracheostomy in critically ill patients.- Emergency percutaneous tracheostomy.- Tracheostomy tube.- Airway management during tracheostomy.- Part 3 Tracheostomy, management and practical aspects.- Medical and nursing management of tracheostomy.- Quality of life and complication after percutaneous tracheostomy.- Clinical practice of informed consent for percutaneous tracheostomy.- Part 4 Tracheostomy, the future.- Tracheostomy in intensive care unit, the need of European guidelines.