Tracheostomy
Medical Author:
Jerry R. Balentine, DO, FACEPMedical Editor:
William C. Shiel, JR, MD, FACP, FACR
Previous contributing medical author:
James K. Bredenkamp, MD, FACS
What is a tracheostomy?
A tracheostomy is a surgically created opening in the neck leading directly to the trachea (the breathing tube). It is maintained open with a hollow tube called a tracheostomy tube.
Why is a tracheostomy performed?
A tracheostomy is usually done for one of three reasons: (1) to bypass an obstructed upper airway (an object obstructing the upper airway will prevent oxygen from the mouth to reach the lungs); (2) to clean and remove secretions from the airway; and (3) to more easily, and usually more safely, deliver oxygen to the lungs.
What are risks and complications of tracheostomy?
It is important to understand that a tracheostomy, as with all surgeries, involves potential complications and possible injury from both known and unforeseen causes. Because individuals vary in their tissue circulation and healing processes, as well as anesthetic reactions, ultimately there can be no guarantee made as to the results or potential complications. Tracheostomies are usually performed during emergency situations or on very ill patients. This patient population is, therefore, at higher risk for a complication during and after the procedure
The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. It is listed here for information only in order to provide a greater awareness and knowledge concerning the tracheostomy procedure.
- Airway obstruction and aspiration of secretions (rare).
- Bleeding. In very rare situations, the need for blood
products or a
blood transfusion.
- Damage to the larynx (voice
box) or airway with resultant permanent change in voice (rare).
- Need for further and more aggressive surgery
- Infection
- Air trapping in the surrounding tissues or chest. In
rare situations, a chest tube may be required
- Scarring of the airway or erosion of the tube into
the surrounding structures (rare).
- Need for a permanent tracheostomy. This is most
likely the result of the disease process which made the a tracheostomy
necessary, and not from the actual procedure itself.
- Impaired swallowing and vocal function
- Scarring of the neck
Obviously, many of the types of patients who undergo a
tracheostomy are
seriously ill and have multiple organ-system problems. The
doctors will
decide on the ideal timing for the tracheostomy based on the
patient's
status and underlying medical conditions.
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