Tracheostomy Complications Over 5 Years: Decannulation Analysis

Document Type : Original

Authors

1 Department of ENT, Command Hospital Airforce Bangalore, Rajiv Gandhi University of Health Sciences, India.

2 Department of Anaesthesia, Command Hospital Bangalore, Rajiv Gandhi University of Health Sciences, India.

Abstract

Introduction:
Tracheostomy is a life-saving surgical intervention commonly performed in patients requiring prolonged mechanical ventilation. However, the decannulation process is associated with various complications that can affect patient outcomes. This study aimed to assess complications and their management during decannulation in a cohort of tracheostomy patients at a tertiary care hospital, considering the complexities introduced by prior intubation.
Materials and Methods:
A retrospective cohort study was conducted involving 450 patients who underwent tracheostomy during a stipulated timeframe. Data regarding demographic characteristics, complications, and management strategies during decannulation were analysed. Special attention was given to distinguishing between complications directly related to the tracheostomy procedure and those potentially influenced by previous intubation.
Results:
Out of the 450 patients, 250 experienced minor complications such as localized bleeding, oxygen desaturation, and minor infections. Another 40 faced major complications including severe haemorrhage, tracheal damage, and stenosis. Increasing age and tracheostomy duration were identified as significant predictors of complications. Pharmacological treatments, surgical interventions, and respiratory therapy were among the management strategies employed. The differentiation between complications arising from tracheostomy and prior intubation highlighted the need for comprehensive patient evaluation.
Conclusion:
Complications associated with decannulation occur frequently with varying severity. Efficient recognition and management of these complications are vital for improving patient outcomes. The study provides important insights into the challenges experienced during the decannulation process and highlights the necessity of considering prior intubation history in the management of tracheostomy decannulation to refine patient care protocols.

Keywords

Main Subjects

References

  1. Goldenberg D, Ari EG, Golz A, Danino J, Netzer A, Joachims HZ. Tracheotomy: changing indications and a review of 1,130 cases. J Otolaryngol. 2002; 31(4):211-215.
  2. Mirza S, Cameron DS, Murgu SD. Tracheostomy tube placement: early and late complications. J Bronchology Interv Pulmonol. 2015; 22(4):357-364.
  3. Choate K, Barbetti J, Currey J. Tracheostomy decannulation failure rate following critical illness: a prospective descriptive study. Aust Crit Care. 2009; 22(1):8-15.
  4. Young D, Harrison DA, Cuthbertson BH, Rowan K. Effect of early vs late tracheostomy placement on survival in patients receiving mechanical ventilation: the TracMan randomized trial. JAMA. 2013; 309 (20): 2121-2129.
  5. Epstein SK. Late complications of tracheostomy. Respir Care. 2005;50(4):542-549.

 

Iranian Journal of Otorhinolaryngology
Volume 36, Issue 4
July and August 2024
Pages 559-565

Files

Share

How to cite

Statistics