Complications of tracheostomy.

Tracheostomy used to be reserved for the severely ill patient with acute respiratory obstruction. As the incidence of diphtheria declined the operation came to be performed only occasionally, particularly as the high mortality and complication rates associated with the use of tracheostomy in diphtheria were well remembered. But within the past 20 years a great change has occurred as the indications for tracheostomy have widened to include tracheal and bronchial toilet (Galloway, 1943), intermittent positive-pressure ventilation of the lungs (Lassen, 1953), protection against inhalation of foreign matter (Taylor and Austin, 1951), and reduction of dead space (Carter and Giuseffi, 1951). This increased use of tracheostomy has undoubtedly prevented many deaths from diseases which formerly were inevitably fatal. However, the former high complication rate may well have been overlooked as enthusiasm for the operation increased, and little information is now available on the incidence and types of complications of tracheostomy.