Some patients in ICU may have different degrees of consciousness, respiratory function, cough and sputum or swallowing dysfunction for a long time, so tracheotomy is one of the most common treatment measures in ICU nowadays. Many patients and their families do not know much about tracheotomy and are afraid of it, and some of them even worry that it will cause the patient to be unable to speak from now on. In fact, tracheotomy is a standard treatment for patients who require manual means to keep the airway open and drain sputum for a long time. A tracheotomy is a procedure in which a tracheal tube is inserted through a cervical approach through a layer-by-layer incision or puncture into the tracheal wall (usually between the 2nd and 4th tracheal rings below the laryngeal nodes). Since the procedure is performed below the vocal cords, the anatomy of the vocal cords is not disrupted. If the patient’s condition improves, normal vocalization is possible after removal of the tracheal tube to close the incision. In addition, some patients who need to wear a tracheal tube for a long time can communicate equally well with others through a special cannula device. Tracheotomy is not difficult and can usually be done in the ICU ward, but because patients undergoing surgical operation are often in poor underlying condition, the surgeon should have a detailed preoperative conversation with the patient or family before considering tracheotomy to inform them of the reasons for the operation and the possible complications associated with the operation, and the family must be fully informed and sign an informed consent form for the operation. The main indications for tracheotomy in ICU include: 1. various reasons for the patient’s own inability to effectively protect airway patency and sputum drainage; 2. respiratory failure, requiring artificial respiratory support and little possibility of recovery of respiratory function within a short period of time. Complications of tracheotomy include: postoperative bleeding, tube displacement or dislocation, incisional infection, subcutaneous emphysema, subsonic granulation and stenosis, etc. With the placement of a tracheal tube the patient breathes in and out mainly through the tracheal tube, which helps to reduce respiratory work and functional exercise. In addition, suctioning and nebulization can be performed through the cannula. The risk of airway blockage is reduced compared to tracheal intubation, the comfort of wearing the cannula is improved compared to tracheal intubation, and in some cases, the quality of daily life is not seriously affected even if the tracheal cannula is placed for a long time due to the condition.