Complications of midline‐open tracheotomy in adults

Straetmans, Jos; Schlöndorff, G.; Herzhoff, Gabi; Windfuhr, Jochen P.; Kremer, Bernd

doi:10.1002/lary.20703

Cited by 27 publications

(20 citation statements)

References 32 publications

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“…However, the fact that mortality following tracheotomy is higher in cardiac conditions and lower conditions such as muscular dystrophy and upper airway infection strongly suggests that the tracheotomy itself is rarely the cause of death 5, 6. This is certainly in accord with the authors' personal experiences, in that most patients who die with a tracheotomy in place die of an underlying disease rather than a tracheotomy complication 7, 8…”

Section: Discussionmentioning

confidence: 60%

Tracheotomy outcomes and complications: A national perspective

et al. 2011

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Objectives/Hypothesis To provide national level data on frequency of tracheotomy and complication rate and in-hospital mortality following tracheotomy. Study Design Retrospective cohort study. Methods Retrospective cohort study using a public national database, the Nationwide Inpatient Sample, 2006. Results There were 113,653 tracheotomies performed in patients 18 years or older in 2006. The overall complication rate was 3.2%, and the in-hospital mortality rate was 19.2%. The data suggest that in-hospital mortality is usually due to the underlying illness rather than the tracheotomy. Mortality was higher in patients older than 50 years, those with cardiac conditions, particularly congestive heart failure, those with public insurance, and patients in Northeast hospitals. Patients with neurologic conditions, trauma, and upper airway infection are more likely to survive to discharge. In-hospital mortality is slightly higher in nonteaching hospitals. Conclusions This database study determined baseline data for the rate of complications (3.2%) for patients undergoing tracheotomy; it showed that only 80% of adult patients who underwent tracheotomy in the United States survived to discharge. Patients located in the Northeast, patients more than 50 years old, and patients with cardiac conditions were at particularly high risk for mortality. This study provides normative data for these outcomes for patient counseling and planning future quality improvement initiatives in this patient population.

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Section: Discussionmentioning

confidence: 60%

Tracheotomy outcomes and complications: A national perspective

et al. 2011

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“…Newer studies have reported lower complication rates of around 9-15 % [8,9]. The likelihood of complication increases significantly when it is performed in emergency setting [5].…”

Section: Discussionmentioning

confidence: 99%

“…Bleeding vessel in thyroid substance was tied off in one patient, while diffuse ooze from peritracheotomy surface was managed with pressure packing in the second. The third patient had on and off ooze from peristomal region and was managed with local (9) hemostatic measures. Patients with posttracheotomy subcutaneous emphysema were managed successfully with observation.…”

Section: Outcomementioning

confidence: 99%

Tracheotomy in Cancer Patients: Experience from a Cancer Hospital in Pakistan

et al. 2014

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Tracheotomy is commonly performed for the management of upper airway compromise. Trauma and head and neck cancers are the most frequent indications. The objective of this study was to share our experience with tracheotomy performed for a broad range of malignancies including but not limited to head and neck cancer. This study is a retrospective case series of patients who underwent tracheotomy from January 2004 to June 2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. A total of 130 patients were included in the study. Patient demographics, indications for tracheotomy, underlying malignancy, and duration of follow-up were assessed. Main indications were elective (prolonged intubation and/or as a prerequisite for head and neck cancer surgery) and emergency (stridor). Outcome was assessed on a basis of successful decannulation and complications related to tracheotomy. Indications for tracheotomy were elective in 55 (44.7 %) and emergent in 75 (55.3 %) patients. Most common underlying malignancy was leukemia/lymphoma in 38 (29.2 %) patients. There were seven (5.3 %) complications in emergency tracheotomies including bleeding in three, emphysema in two, and dislodgement and infection in one patient each. In the elective setting, three (2.3 %) complications were observed with dislodgement in one and stomal stenosis in two patients. Decannulation was successfully carried out in 23 (18 %) patients. Median followup of patients was 1 month (range 0-86). No tracheotomyrelated mortality was observed. Tracheotomy was performed with relative safety in cancer patients, but low rate of successful decannulation predominantly due to persistent nature of disease.

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“…Open tracheotomies are safe procedures even when performed in high‐risk patients by inexperienced surgeons 1. Reported complications associated with the well‐known percutaneous dilatational tracheotomy (PDT) techniques are due to either predilatory dissection or the downward forces applied to the surrounding tissues and posterior tracheal wall during dilation 2.…”

Section: Introductionmentioning

confidence: 99%