Complications can be divided into those associated with insertion of the tracheostomy (usually a surgical insertion in children although percutaneous insertions are possible) or those which arise following the procedure (usually blocked or displaced tracheostomy tubes). Post-insertion problems are much more common.
These can be serious and sometimes fatal.
These complications are usually grouped as follows:
Perioperative
Perioperative complications include:
- Bleeding
- Subcutaneous emphysema
- Pneumothorax (chest drain)
- Accidental decannulation and difficulty replacing the tracheostomy
Postoperative
Postoperative complications include:
- Tube obstruction
- Infection (stoma, tracheitis, lower respiratory tract infection (LRTI))
- Granulations (stomal, supra-stomal, infra-tip)
- Suprastomal collapse
- Tracheomalacia/stenosis
- Delayed speech development (speaking valve)
- Persistent tracheocutaneous fistula
- Tracheo-oesophageal fistula (TOF)
- Decannulation