Post-Tracheostomy Steroid Nebulization: A Retrospective Analysis on Postoperative Complications

The primary objective of this research was to meticulously evaluate the therapeutic potential of steroid nebulization, administered over a 2-week period post-tracheostomy, in attenuating postoperative complications with a concentrated emphasis on tracheal stenosis. The study spanned three years, commencing in 2019 and concluding in 2022, examining a patient cohort of 400 individuals. Utilizing a retrospective cohort methodology, the participants were systematically stratified into two cohorts: those subjected to steroid nebulization (n = 200) and a control group (n = 200). Adverse outcomes were bifurcated into minor complications, which encompass stomal infections and inflammations, and major complications, which include bleeding, tracheoesophageal fistula, and tracheal stenosis. These complications were evaluated at distinct post-operative junctures: 1 week, 1 month, 3 months, and 6 months. The primary outcome was deduced through a rigorous multivariate logistic regression model, incorporating variables such as age, sex, and the diagnosis of chronic obstructive pulmonary disease (COPD). Analytical data unveiled that the cohort administered with steroid nebulization manifested a statistically significant diminution in the incidence of complications when juxtaposed with the control group (25 vs. 38%). Predominantly, the incidence of tracheal stenosis was discernibly lower in the steroid nebulization group (10 vs. 22%). The multivariate analytical framework further corroborated the pivotal role of steroid nebulization in substantially reducing the propensity for tracheal stenosis. The therapeutic intervention of steroid nebulization in the aftermath of a tracheostomy procedure presents a commendable avenue in curtailing major complications, with an acute focus on tracheal stenosis. To fortify these preliminary findings, it is quintessential to undertake more exhaustive studies, such as randomized controlled trials, to ascertain the optimal regimen concerning nebulization's timing, dosage, and duration.