Instructive complications associated with tracheostomy

Recently, tracheostomy has been utilized widely, both in critical and intensive care patients, as a means of providing more secured airways, especially for those who require intensive and long-term respiratory care. In brief, tracheostomy-once considered an emergency procedure-has not become one of the elective procedures for such patients.However, tracheostomy complications such as bleeding, infection, emphysema, granulations, tracheal stenosis and other post-tracheostomy complications still are encountered in some cases even in skilled and experienced hands.Among 210 of our recent tracheostomy cases, there were four most informative cases of tracheostomy complications encountered during tracheostomy and in the post-tracheostomy period, suggesting the importance of proper selection of the cannula, atraumatic technique, fixation and position of the cannula, and prevention of post-operative granulation formation. In a fifth and very unusual case, a suture was accidentally swallowed and lodged at the esophageal orifice and remained until routine post-tracheostomy X-ray taken approximately 4 weeks later.The carefully planned and practiced tracheostomy with endotracheal tube in place under optimal anesthetic state would be the choice in avoiding such unfavorable complications.