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What Are the Risks of a Tracheostomy?

As with any surgery, a tracheostomy procedure can cause complications. Some complications are more likely to occur soon after the procedure is done. Others are more likely to happen over time.

Some complications are related to the tube that is put through the tracheostomy into the windpipe (the trach tube).

Proper care and handling of the tracheostomy and the tubes and other related supplies can help reduce risks.

Immediate Complications

Complications that can occur shortly after surgery include:

  • Bleeding and infection.
  • Pneumothorax (noo-mo-THOR-aks). This is a condition in which air or gas builds up in the space between the lungs and chest wall. Pneumothorax can cause sudden pain in one side of the lung and shortness of breath. The condition also can put pressure on the lung and cause it to collapse.
  • Subcutaneous emphysema (sub-ku-TA-ne-us em-fi-SE-ma). This is a condition in which air gets trapped beneath the skin.

Later Complications

Over time, other complications can develop. For example, infections may scar the windpipe. A fistula (FIS-tu-lah), or abnormal connection, may form between the windpipe and esophagus. (The esophagus is the passage leading from your mouth to your stomach.)

A fistula between the windpipe and esophagus can cause food and saliva to enter the lungs and possibly cause pneumonia. Symptoms of a fistula include severe coughing and trouble breathing.

Trach Tube Complications

Some complications are related to the trach tube. For example, the tube may slip or fall out of the tracheostomy. Other problems include:

  • Abnormal tissue masses, or granulations (GRAN-u-LA-shuns), in the airways
  • Narrowing or collapse of the airway above the trach tube's location
  • Irritation of the windpipe's inside lining from the tube rubbing against the lining's surface
  • Blockage of the tracheostomy from dried secretions and mucus masses (also called plugs)
  • Infection
  • Failure of the tracheostomy to close on its own after the trach tube is removed
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Last Updated: March 19, 2012