Risks

Tracheostomies are generally safe, but they do have risks. Some complications are particularly likely during or shortly after surgery. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure.

Immediate complications include:

• Bleeding
• Damage to the trachea, thyroid gland or nerves in the neck
• Misplacement or displacement of the tracheostomy tube
• Air trapped in tissue under the skin of the neck (subcutaneous emphysema), which can cause breathing problems and damage to the trachea or food pipe (esophagus)
• Buildup of air between the chest wall and lungs (pneumothorax), which causes pain, breathing problems or lung collapse
• A collection of blood (hematoma), which may form in the neck and compress the trachea, causing breathing problems

Long-term complications are more likely the longer a tracheostomy is in place. These problems include:

• Obstruction of the tracheostomy tube
• Displacement of the tracheostomy tube from the trachea
• Damage, scarring or narrowing of the trachea
• Development of an abnormal passage between the trachea and the esophagus (tracheoesophageal fistula), which can increase the risk of fluids or food entering the lungs
• Development of a passage between the trachea and the large artery that supplies blood to the right arm and right side of the head and neck (tracheoinnominate fistula), which can result in life-threatening bleeding
• Infection around the tracheostomy or infection in the trachea and bronchial tubes (tracheobronchitis) and lungs (pneumonia)

If you still need a tracheostomy after you've left the hospital, you'll need to keep regularly scheduled appointments for monitoring possible complications. You'll also receive instructions about when you should call your doctor about problems, such as:

• Bleeding at the tracheostomy site or from the trachea
• Difficulty breathing through the tube
• Pain or a change in comfort level
• Redness or swelling around the tracheostomy
• A change in the position of your tracheostomy tube