Late complications of tracheostomy.
Tracheostomy may be associated with numerous acute, perioperative complications, some of which continue to be relevant well after the placement of the tracheostomy. A number of clinically important unique late complications have been recognized as well, including the formation of granulation tissue, tracheal stenosis, tracheomalacia, tracheoinnominate-artery fistula, tracheoesophageal fistula, ventilator-associated pneumonia, and aspiration. The clinical relevance of these complications is considerable, as their manifestations range from minimally symptomatic to failure to wean from the ventilator (tracheal stenosis) to life-threatening hemorrhage (tracheoinnominate fistula). Treatment modalities vary depending upon the nature of the complication. For the most frequent complication, tracheal stenosis, a multidisciplinary approach utilizing bronchoscopy, laser, airway stents, and tracheal surgery is most effective.
Epstein
Scott K
SK
Department of Medicine, Caritas-St Elizabeth's Medical Center, 736 Cambridge Street, Boston MA 02135, USA. scott.epstein@tufts.edu
D001159:Arterio-Arterial Fistula / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D011014:Pneumonia / Q000209:etiology / Q000517:prevention & control; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D014132:Trachea / Q000098:blood supply; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000517:prevention & control; D014139:Tracheostomy / Q000009:adverse effects*