[abbythetabby]

Hey,

Can anyone help me out with the causes of tracheostomy complications?

Thanks!

[RNsRWe]

Do you mean complications arising from the surgery itself, or undesirable conditions that may occur later, during the care and maintenance of one?

[augigi]

(Just at this part in my NCLEX review, so this is from Saunders)

- Tube obstruction (by secretions)
- Tube dislodgement (client movement, traction on tube, incomplete attachment of the inner and outer cannulae)
- Tracheomalacia: (tracheal dilation and erosion by pressure of the tube)
- Tracheal stenosis: (scar formation from irritated mucosa)
- Tracheoesophageal fistula: (Erosion of posterior trachea wall from excessive cuff pressure, risk increased with concurrent NG tube)
- Trachea-innominate artery fistula: (necrosis and erosion of the innominate artery by the malpositioned tube - emergency)

In practise, 9/10 complications are caused by sputum plugs obstructing the trach tube and are fixed by suctioning/repositioning/coughing/humidification/cleaning inner lumen.

[abbythetabby]

Originally Posted by RNsRWe

Do you mean complications arising from the surgery itself, or undesirable conditions that may occur later, during the care and maintenance of one?

Sorry to be unclear. I meant complications that occur a month or longer after surgery.

Augigi, thanks! Everywhere I looked, I found the same list of complications but no reason as to why. I could guess, but wasn't sure I was getting all the "whys".

The only other one I have is granulomas. The tube is a foriegn body, so the pt's immune system may mount a response.

[Daytonite]

You should find the information you are looking for among these websites:

http://www.medicinenet.com/tracheostomy/article.htm - a nice list of the complications is listed here along with the causes

http://www.surgical-tutor.org.uk/default-home.htm?specialities/ent/tracheostomy.htm~right - nice, concise listing that includes the immediate, intermediate and late complication of tracheostomy. To find more information of the late complications I would do a search on e-medicine for the specific condition.

http://www.emedicine.com/ent/topic356.htm#section~complications - this article from e-Medicine has information about the late complications of tracheostomy: bleeding, tracheomalacia, stenosis, tracheoesophageal fistula, tracheocutaneous fistula, granulation, scarring, and failure to decannulate.

http://www.orthonurse.org/education/ce/marapr2k/tracheos/sec5text.htm - Care of the Patient with a Tracheostomy. Includes complications in early and late stages, causes of them and prevention.

http://www.thoracic.org/sections/education/care-of-the-child-with-a-chronic-tracheostomy/index.html - Care of the Child with a Chronic Tracheostomy. At this same site is a short discussion on complications of tracheostomies http://www.thoracic.org/sections/education/care-of-the-child-with-a-chronic-tracheostomy/components-of-tracheostomy-care/complications.html that will give you an idea of some of the problems that may be encountered even though it is talking about pediatric patients.

[abbythetabby]

Thanks Daytonite!

The third link filled in the gaps for me.