Immediate (During Insertion)
- Arrest and Death (1/600)
- Haemorrhage (minor or severe) - 4.8%
- Misplacement (pre-tracheal tissues or to main bronchus)
- Hypoxia
- Injury to local structures:
- Pneumothorax and surgical emphysema
- Oesophageal perforation
- Vascular injury
- Thyroid injury
- Posterior tracheal wall injury
- Laryngeal nerve damage
- Tracheal ring fracture
- Air embolism
- Equipment issues:
- Incorrect tube / size
- Equipment malfunction
Delayed (Post Insertion)
- Tube blockage with secretions (may be sudden or gradual)
- Tube migration to pre-tracheal space
- Accidental decannulation
- Infection:
- Stoma site
- Bronchial tree
- VAP
- Erosion related:
- Tracheal ulceration or necrosis
- Tracheo-oesophageal fistula formation
- Tracheo-innominate fistula
Late (Post Decannulation)
- Tracheal injury / dysfunction:
- Tracheal stenosis at the cuff site
- Tracheomalacia
- Vocal cord dysfunction
- Persistent sinus at the tracheostomy site
- Granulomata of the trachea
- Tracheo-innominate fistula
- Psychological impact related to stoma