What Are The Pros And Cons Of A Tracheostomy?

In an emergency, a tracheostomy procedure can save lives when other airway management techniques do not bring good results.1

There are several potential benefits of using a tracheostomy when compared to a mechanical ventilator because it reduces sedation requirements.2,3

If a laryngectomy was done for cancer, then tracheostomy is the only available choice that assists the patients with breathing however in some instances it is accompanied by an inherent risk of complications.4

What Are The Pros And Cons Of A Tracheostomy?

Clinical studies demonstrate that early tracheostomy can reduce complications and decrease death rates in ventilated patients. In a nutshell, the tracheostomy procedure is also called a lifesaver saving lives when other breathing techniques fail. Here in this blog, you will learn more about the advantages and disadvantages of tracheostomy. 1

Pros Of Tracheostomy

Improved Patient Comfort – Tracheostomies are generally more comfortable than tubes in the mouth. Patients in the intensive care require less sedation by facilitating oral and bronchopulmonary toilet. However, intubated intensive care unit patients are sedated for overall comfort and safety to address both physiologic and psychological needs.

Enhanced Ability To Communicate – Although tracheostomy affects the ability to talk, yet there are numerous methods to communicate that include gestures, writing pads, communication boards, and a few other modes. When you have problems with speaking, a speech therapist can help assist with your request.

Better Than A Mechanical Ventilator – Tracheostomy has several pros over ventilator in patients undergoing PMV for easier oral care and suctioning, reduced accidental extubation that aids faster recovery. It has potential benefits in protecting the larynx from injury caused by a translaryngeal tube.2,3

Cons Of Tracheostomy

The cons of tracheostomy include the below:

Pain And Trauma: Emergency tracheostomy is often painful and placement can perhaps be very scary especially in newborn infants, alcohol abusers, immunocompromised patients, and individuals under drugs.

The Complications With A Tracheostomy– One of the common complications with a tracheostomy is obstruction of the tracheostomy tube. The other complications include Hypoxia, airway trauma, infection, pain and bleeding, and ineffective suctioning.

Survivability After Tracheostomy- There is no proven evidence to show that the tracheostomy tube is helpful in the long-term. The median survival period of patients after tracheostomy is 21 months. The survival rate is 65 percent in the first year which gradually reduces to 45 percent in the second year. However, the prognosis of tracheostomy in patients over 60 years is not significant with a hazard ratio of 2.1 percent.4

Although there are risks involved with emergency tracheostomy such as bleeding, pneumothorax (collapsed lung), pneumomediastinum (abnormal presence of gas due to trauma or leakage in the windpipe) many of these complications can be appropriately avoided with experienced surgeons. The putative benefits of tracheostomy far outweigh the cons of tracheostomy.

A tracheostomy is a surgical procedure of creating a hole in front of the neck to help to breathe on patients faced with serious respiratory illness. The requirement for tracheostomy continues to increase in long-term care. As per clinical theory tracheostomy is typically performed after an episode of failed intubation for airway obstruction, problems with secretion, and insufficient oxygen delivery.

The quality of life is good with a permanent tracheostomy tube; however, some patients still have problems with swallowing and communicating. Nevertheless, your healthcare team will help you with all your questions and train you on how to look after tracheostomy.

References:

  1. Nickson, Chris. “Tracheostomy, Advantages and Disadvantages • LITFL • CCC Airway.” Life in the Fast Lane • LITFL • Medical Blog, 3 Nov. 2020, litfl.com/tracheostomy-advantages-and-disadvantages/.
  2. Nazario, Brunilda. “Tracheostomy: Procedure, Risks, and Results.” WebMD, WebMD, 13 July 2020, www.webmd.com/lung/lung-tracheostomy.
  3. Mamastrobel@gmail.com. “Trach – Pros/Cons.” ALS Support Community, ALS Support Community, 10 Jan. 2016, www.alsforums.com/community/threads/trach-pros-cons.30983/.
  4. “What Are the Advantages and Disadvantages of the Bivona Tracheostomy Tube?” Latest Medical News, Clinical Trials, Guidelines – Today on Medscape, 12 Nov. 2019, www.medscape.com/answers/865068-32787/what-are-the-advantages-and-disadvantages-of-the-bivona-tracheostomy-tube.

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