Tracheostomy - Complications of a tracheostomy

Having a tracheostomy is considered to be a safe and straightforward procedure, but as with many medical procedures it does carry a risk of complications.

The likelihood of complications occurring will depend on:

• your age and general health
• the reason why you need the tracheostomy

Generally, a planned tracheostomy carries a lower risk of complications than an emergency tracheostomy.

Early complications

Complications that can occur during or shortly after a tracheostomy are outlined below.

Bleeding

Any surgical procedure can be complicated by bleeding, which can be minor or major. If there is significant blood loss, a blood transfusion may be necessary.

Collapsed lung

Sometimes, air will collect around the lungs and cause the lungs to collapse inwards. This is known as a pneumothorax. In mild cases, this often corrects itself without the need for treatment. In more serious cases, a tube will need to be surgically implanted into the chest to drain the air away from the lungs.

Accidental injury

The nerves near the windpipe can be accidentally damaged, such as those controlling the voicebox (larynx) or the oesophagus (the tube that runs from the back of the throat to the stomach). This may cause problems with speaking and swallowing.

Infection

The windpipe or nearby tissues can become infected with bacteria. These usually need to be treated with antibiotics.

Late complications

Complications that can occur days, weeks or even months after a tracheostomy are described below.

Failure to heal

Sometimes, the tracheostomy wound will not heal properly and starts to bleed. If this happens, the tracheostomy tube may need to be temporarily removed so that surgery can be carried out to stem the bleeding.

Collapsed windpipe

Sometimes the windpipe collapses in on itself because the walls of the windpipe are not strong enough to support it. This usually occurs when the tracheostomy tube has not been fitted properly, and it requires further surgery.

Breathing difficulties

Any form of accidental damage to the throat can result in the airways becoming narrowed, which can cause breathing difficulties. Surgery may be needed to widen the airways. This may involve implanting a small tube called a stent to keep the airways open.