Tracheostomies are generally safe, but they do have risks. Some complications are particularly likely during or shortly after surgery. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure. Immediate complications include:

  • Bleeding
  • Damage to the trachea
  • Air trapped in tissue under the skin of the neck (subcutaneous emphysema), which can cause breathing problems and damage to the trachea or food pipe (esophagus)
  • Buildup of air between the chest wall and lungs (pneumothorax), which causes pain, breathing problems or lung collapse
  • A collection of blood (hematoma) may form in the neck and compress the trachea, which causes breathing problems
  • Misplacement or displacement of the tracheostomy tube

Long-term complications are more likely the longer a tracheostomy is in place. These problems include:

  • Displacement of the tracheostomy tube from the trachea
  • Narrowing of the trachea
  • Abnormal tissue formation in the trachea
  • Obstruction of the tracheostomy tube
  • Development of an abnormal passage between the trachea and esophagus (fistula), which can increase the risk of fluids or food entering the lungs
  • Development of a passage between the trachea and the innominate artery (tracheoinnominate fistula), which can generate life-threatening bleeding
  • Infection
  • Bacterial colonization, which may cause illness, such as pneumonia

If you still need a tracheostomy after you've left the hospital, you'll need to keep regularly scheduled appointments for monitoring possible complications. You'll also receive instructions about when you should call your doctor about problems, such as:

  • Bleeding at the tracheostomy site or from the trachea
  • Difficulty breathing through the tube
  • Pain or a change in comfort level
  • Redness
  • Swelling
  • A change in the position of your tracheostomy tube