Duke GJ, Moran JL, Santamaria JD, et al. - Researchers undertook this retrospective study to determine the safety of endotracheal tube (ETT) vs tracheostomy tube (TT) for mechanical ventilation (MV) support in the intensive care unit (ICU). They used five year national dataset of 128,977 adults (age > 15-years) who were admitted for MV therapy with tracheostomy tube (TT; n = 4,772) or without (ETT; n = 124,204) in 93 public health service ICUs across Australia. An increment in the temporal trend for ETT vs TT was evident, even for prolonged (> 3 weeks) MV (38.1%). Higher risk-adjusted mortality was identified to be related to longer span of MV and after 9 days of MV with retention of ETT vs TT - average (mortality) treatment effect 12.6% (95%CI =10.7–14.5). The latter was not significant following 30 days of MV. As concluded by experts, there remains uncertainty regarding the safety of ETT vs TT beyond short-term MV (≤9-days), and there is a need for prospective assessment with additional data.