Complications can be considered as immediate (during the procedure), delayed (post-procedure) or late (following decannulation). Give 5 examples of immediate complications?

Immediate (During Insertion)
  • Arrest and Death 1 (1/600)
  • Haemorrhage (minor or severe) 1 4.8%
  • Misplacement (pre-tracheal tissues or to main bronchus) 1
  • Hypoxia 1
  • Injury to local structures:
    • Pneumothorax and surgical emphysema 1
    • Oesophageal perforation 1
    • Vascular injury 1
    • Thyroid injury 1
    • Posterior tracheal wall injury 1
    • Laryngeal nerve damage 1
    • Tracheal ring fracture 1
  • Air embolism 1
  • Equipment issues: 1
    • 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