Complications to tracheostomy and long-term intubation: a follow-up study

Hospital records of 79 patients treated with tracheostomy or long-term intubation from 1969 to 1971 were reviewed, and the 43 surviving patients were examined by laryngoscopy, x-ray and spirometry for complications subsequent to these treatments. Early complications included one tube occlusion and one case of postextubation stridor in each group, one dislocated tube, one bilateral pneumothorax, and one case of fatal innominate arterial hemorrhage in the tracheostomy group, and two cases of atelectasis in the long-term intubation group. Necropsy findings included necrotic ulcers in the larynx of intubated patients and eroded tracheal mucosa in both groups. Late complications in surviving patients were prolonged hoarseness in six patients treated with prolonged intubation, two of whom had also had tracheostomy. Radiologically verified tracheal stenosis (40-60%), four at the stoma level and one at the cuff level, all occurred in the tracheostomy group.