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Who Needs a Tracheostomy?

People of all ages may need tracheostomies for various reasons.

People Who Are on Ventilators

A common reason for needing a tracheostomy is the use of a ventilator (VEN-til-a-tor) for more than a couple of weeks.

A ventilator is a machine that supports breathing. It's connected to a tube that is put through the tracheostomy. This tube often is called a trach tube. The tube carries oxygen-rich air from the ventilator to the lungs.

For people who are on ventilators and awake, a trach tube might be more comfortable than a breathing tube put through the nose or mouth and down into the windpipe. A trach tube also makes it possible for some people who are on ventilators to eat and talk.

Depending on your reason for needing a ventilator, your tracheostomy might be temporary or permanent. If you need a ventilator for the rest of your life, your tracheostomy will likely be permanent.

If your doctor decides that you can stop using the ventilator, you may no longer need the tracheostomy. You can then let the hole close up, either on its own or with surgery.

People Who Have Conditions That Affect Coughing or Block the Airways

Your doctor might recommend a tracheostomy if you have trouble coughing. Coughing is a natural reflex that protects your lungs. It helps clear mucus and bacteria from your airways. If you have trouble coughing, a trach tube can help suction mucus from your airways.

Your doctor also might recommend a tracheostomy if you have a condition that obstructs, or blocks, your upper airways. Examples of diseases, conditions, and other factors that might interfere with coughing or block your upper airways include:

  • Congenital defects of the upper airways (in children). “Congenital” means that the defects are present at birth.
  • Airway injuries from smoke, steam, or chemical burns.
  • Severe allergic reactions or infections.
  • Removal of the larynx (for example, from cancer).
  • Long-term coma.
  • Neuromuscular diseases that paralyze or weaken the muscles and nerves involved in breathing.
  • Spinal cord injuries.

Some of these conditions are temporary. Once you recover enough to breathe easily and safely on your own, you may no longer need the tracheostomy. Other conditions may require you to have a tracheostomy long term or even permanently.

People Who Have Swallowing Problems

Your doctor may recommend a tracheostomy if you have trouble swallowing due to a stroke or other condition. You may need the tracheostomy until you can swallow normally again.

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March 19, 2012