Risks and Complications of Tracheostomies: What You Need to Know
Though the number of tracheostomies performed each year has decreased from its peak of 80,612 in 2002, it is still a common procedure. In fact, the most recent data shows that we saw 58,840 tracheostomies in 2017.
If you are expecting to have a tracheostomy (or if you’ve had a recent emergency procedure), it’s important to note that complications are rare but not entirely impossible. In this article, we’ll talk about what a tracheostomy is and all of the complications that can arise from one. Finally, we’ll talk about prevention.
Read on to learn more!
What is a Tracheostomy Procedure?
A tracheostomy procedure, like any other surgery, is done under general anesthesia. During the procedure, the surgeon makes a small incision in the neck and places a tube through the opening. This tube provides access to the windpipe, allowing the patient to breathe better.
A tracheostomy tube is sometimes placed during an emergency procedure, though it is usually performed in a hospital setting. There are fewer complications when they are performed at a hospital.
Here are some of the reasons for tracheostomy tube procedures:
- Airway blockages. If someone has something stuck in their windpipe, suffers damage to their windpipe resulting in swelling/narrowing, or has a cancerous tumor, it can cause a blockage of the airway and would require a tracheostomy tube.
- Respiratory failure. If the patient cannot breathe on their own, a tracheostomy can help make it easier. If a person is unconscious, is paralyzed from a spinal cord injury, has serious lung damage or has a condition that results in nerve damage, they could experience respiratory failure that would result in the placement of a tracheostomy tube.
- To remove fluid buildup. If a patient is unable to expectorate (cough up mucus) due to weakness or paralysis, has a serious lung infection, or their airways are full of blood as a result of serious injury, a tracheostomy tube can help remove the fluid.
What Complications Can Arise During Surgery?
During surgery, the surgeon will work to prevent the following complications:
- Displacement or misplacement of the tracheostomy tube
- Pooling of blood/hematoma in the neck (a condition which may compress the trachea, resulting in breathing problems)
- Recurrent laryngeal nerve injury (a condition in which vocal cords are damaged, resulting in hoarseness or vocal cord paralysis)
- Subcutaneous emphysema (a condition in which air is trapped under the skin of the neck, causing breathing problems and damage to the trachea/windpipe or esophagus/food pipe)
- Tension pneumothorax (a severe condition better known as a collapsed lung, in which air is trapped between the lungs and chest wall, compromising heart function)
- Trachea, thyroid gland, or nerve damage
What Complications Can Show Up Later?
Tracheostomies require expert care, so it’s important to obtain skilled nursing care post-surgery, at least until the caregiving family member can be properly trained on tracheostomy care. Short-term care is a great option for families of patients who expect a full recovery.
Here are some of the complications that can show up after surgery has been performed:
- Accidental decannulation (accidental removal of the tracheostomy tube)
- Development of abnormal passages/fistulas (the passage may be between the trachea and esophagus – a tracheoesophageal fistula – or between the trachea and the large artery that supplies blood to the right arm and right side of the head or neck – a tracheoinnominate fistula)
- Infection (this may be around the tracheostomy, in the trachea and bronchial tubes – tracheobronchitis – or in the lungs – pneumonia)
- Obstruction of the tracheostomy tube
- Windpipe damage due to the tube (the tracheostomy tube may also cause scarring or narrowing of the trachea)
Are There Any Long-Term Complications?
Unfortunately, the longer a tracheostomy tube is in place, the more likely it is that there will be complications.
Here are some of the long-term complications of tracheostomies:
- Failure to close after removal (if it’s been in a long time, the closure may not heal on its own once the tracheostomy tube is removed, requiring additional surgery)
- Granulation tissue (a condition in which small bumps develop near the tracheostomy site – this tissue will need to be removed before the tube is removed)
- Narrowing or collapse of the airway above the tracheostomy site (if this happens, additional surgery may be needed to repair the airway)
- Tracheomalacia (a condition in which the trachea thins out over time due to the tracheostomy tube rubbing against it)
Can You Avoid Tracheostomy Complications?
Taking proper care of your tracheostomy tube should help you avoid some of the common complications with tracheostomies. Because tracheostomy care is unfamiliar territory for you and your family, the best course of action is to seek short-term or long-term care to help provide the care you need.
Remember, there are many complications that can arise from tracheostomy care, and it may be difficult for you to identify when it’s time to call the doctor. At MediLodge, we are adept at caring for a wide range of individuals with unique medical problems. Our caring staff is happy to help. Contact us if you’d like to know more!