Chest surgery clinics of North America
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Tracheostomy is a common procedure used by a wide variety of surgeons. Complications after tracheostomy have been used as a rationale for prolonging a translaryngeal intubation. Understanding the pathogenesis of tracheostomy complications combined with meticulous surgical and perioperative management avoids the majority of complications. The remaining complications are readily managed and should not provide a rationale for denying intubated patients the benefits of tracheostomy.
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TIF is a rare and often fatal complication of tracheostomy. Bleeding from the trachea after tracheostomy demands urgent investigation. ⋯ Prompt operation with division of the innominate artery and separation of the trachea from the divided artery by viable tissue is indicated. Neurologic complications are rare.
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Isolated trauma to the airway is infrequent yet potentially life-threatening. The larynx and cervical trachea are vulnerable to external forces, whether penetrating or blunt, as well as internal injuries from endotracheal or nasogastric intubation and to thermal burns from the inhalation of fumes or the ingestion of caustic substances.