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Complications - Percutaneous dilatational tracheotomy

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Intraoperative complications

    • Bleeding (< 2%)
    • Intratracheal bleeding
    • Tracheal injury/injury to the posterior wall (2,2%)
    • Injury to the cricoid cartilage
    • Pneumothorax (< 1%)
    • Paratracheal malposition (extremely rare)
    • Failed puncture with injury to adjacent organs (carotid artery, esophagus, thyroid)
    • Injury to the recurrent nerve
    • Cardiac arrest by vagal stimulation

  2. Postoperative complications

    • Secondary bleeding during the postoperative stage
    • Cutaneous emphysema (incl. mediastinal emphysema with airway obstruction resulting from a malpositioned or undersized tracheotomy tube. In ventilated patients, air will creep along the blocked cuff.
    • Injury to the posterior airway wall with the possible complication of mediastinitis.
    • Pneumothorax
    • Hemorrhage from eroded major blood vessels
    • Stomal infection (4.8%)
    • Tube obstruction by blood or secretions
    • Late sequela of tracheomalacia/tracheal stenosis resulting from excessively high cuff pressure /<2%) and manifesting as shrinking and scar formation
    • Scarring of the tracheostomy
    • Tracheoesophageal fistula (extremely rare)