Complications of Surgical Tracheostomy

Tracheostomy has a mortality rate of <1% but has a total complications rate as high as 40%.
The complication rate is higher in the ICU and emergency patients.

The complications can be divided into:

1- Immediate
*Hemorrhage
*Tube misplacement (e.g. into main bronchus)
*Occlusion of tube by cuff herniation
*Occlusion of the tube tip against carina or tracheal wall
*Pneumnothorax

2-Delayed
*Blockage of the tube by secretions which can be sudden or gradual; this is rare with adequate humidification and suction
*Infection of the stoma
*Overinflation of the cuff leads to ulceration and distension of the trachea
*Mucosal ulceration because of excessive cuff pressures, asymmetrical inflation of the cuff or tube migration

3-Late
*Granulomata of the trachea may cause respiratory difficulty after extubation
*Persistent sinus at the tracheostomy site
*Tracheal dilation
*Tracheal stenosis at the cuff site
*Scar formation

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