[Complications of tracheotomy].
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| Abstract |
The complications of tracheotomy are reviewed and divided into two categories: early and late complications depending on whether the cannula has been removed or remains in situ. In the acute period, severe haemorrhages (0.3 to 2%) and oesophagotracheal fistulae (0.5 to 2%) result from a conflict between cannula and trachea during prolonged intensive care. Cardiac arrhythmia is frequent during aspiration (35%) but rarely lethal. Various technical problems related to the tracheotomy material are common (4 to 6%) and often very serious. Air leakage is represented mainly by severe pneumothorax (1 to 5%) under artificial ventilation. Tracheotomy wound infections (0.5 to 3.5%) may facilitate pulmonary superinfections (15 to 30%) which have a 5 to 8.5% mortality rate. In the acute phase, the overall mortality rate due to the tracheotomy itself is 1.7% (40 deaths in the 2,692 tracheotomies reviewed). The main post-decannulation complication is tracheal stenosis. The incidence of severe stenosis (more than two-thirds of the tracheal diameter) varies from 8 to 12%. Stenosis is difficult to diagnose unless endoscopic examination is routinely performed. The classical treatment is surgical, but laser is helpful in this as in granulomas. In patients with in-dwelling cannula, granulomas may be responsible for pain, obstruction and bleeding which can be avoided by using an adequate equipment. Chronic invasion of the bronchi by Gram-negative organisms is almost constant and results in episodes of superinfection. Finally, patients with a permanent cannula often have psychological and social problems influencing their quality of life.
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| Authors | F Viau, A Lededente, J Y Le Tinier |
| Journal | Revue de pneumologie clinique (Rev Pneumol Clin) Vol. 44 Issue 1 Pg. 24-32 ( 1988) ISSN: 0761-8417 [Print] France |
| Vernacular Title | Complications de la trachéotomie. |
| PMID | 3291071 (Publication Type: English Abstract, Journal Article, Review) |
| Topics |
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