Temporary tracheostomy is associated with a high complication rate.4,5 A recent study, focused on complications following tracheostomy tube placement (n = 42), reported an 86% (n = 36) complication rate with 10% (n = 4) of all dogs euthanized following occurrence of complications.5 Underlying disease was a major factor in survival with only 60% survival (n = 25) reported in this study, despite 81% of successful tube management in a majority of cases. Similar findings have been reported for cats.
After placement of a tracheostomy tube, the patient should be monitored closely for potentially life-threatening complications. Tube dislodgement affects 13% to 35% of patients that undergo tracheostomy, and obstruction affects 18% to 26%.5
Other possible complications include aspiration pneumonia, tracheal infection or necrosis, tracheal stenosis, pneumomediastinum, pneumothorax, and subcutaneous emphysema.5 During routine care, gagging, vomiting, and vagal reflex may also occur.8
Tracheal stenosis, the most significant long-term complication, will occur to some degree in all cases (25% loss of luminal area 2 months postremoval) but should not be clinically significant if proper technique has been employed.10 It can be circumferential if the tube was too large or the cuff overinflated. The type of tracheal incision (transverse vs others) does not seem to be correlated with risk for complications.6,8
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