Skip to main content
SpringerLink
Log in

Komplikationen der Tracheotomie und Strategien zu deren Vermeidung

  • Chapter
  • First Online:
Kompendium Tracheotomie und Atemwege

  • 2335 Accesses

Zusammenfassung

Tracheotomien sind häufige Eingriffe bei beatmeten Intensivpatienten. Sie können mit schweren Komplikationen verbunden sein, bis hin zum tödlichen Ausgang. Die Komplikationen Blutung, Pneumothorax, Tracheahinterwandverletzungen, intraoperativer Verlust des Atemwegs, Verlust des Atemwegs bei Kanülenwechsel, Trachealringfrakturen, Trachealstenosen und Stomainfektionen werden für die verschiedenen Verfahren und Methoden in zahlreichen Abbildungen, Tabellen und Textbeschreibungen übersichtlich dargestellt sowie Strategien zu deren Vermeidung eingehend abgehandelt. Die Komplikationen werden erstmals im Schrifttum durch konkrete Angaben vergleichend definiert. Die Durchführung der PDT mit starrer endoskopischer Kontrolle wird unter interdisziplinären Aspekten ausführlich beschrieben. Tracheotomie-assoziierten Todesfällen ist ein eigenes Kapitel gewidmet. Das Kapitel ist für den praktisch tätigen Arzt in seinem zentralen Anliegen, Komplikationen zu vermeiden, eine Pflichtlektüre und für Gutachter eine hilfreiche Orientierung.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Tracheotomie-Endoskop für Dilatationstracheotomien (TED nach Klemm): Hersteller Karl Storz GmbH Tuttlingen, Germany, patentiert 30.11.2006, USA Pub. No. US2006/0270907A1 durch Karl Storz GmbH Tuttlingen.

    EC-Declaration of Conformity: Karl Storz GmbH Tuttlingen 16.10.2008, Endoskope E, F, G.

    Tracheoskop nach Aloy-Klemm: Hersteller Carl Reiner GmbH Wien, Austria, mit Anpassung zu TwinStream ™ Multi Mode Respirator der Firma Carl Reiner GmbH Medizintechnik für Diagnose und Therapie Wien, Produktkompatibilitätserklärung Wien 28.01.2008.

Literatur

  • Altmann E, Badaev R, Radynsky E, Croitoru M, Rosin I, Davidova N, Taitelman U (2006) Clinical and experimental assessment of Griggs percutaneous tracheostomy. J An Ints 13: 82–83

    Google Scholar 

  • Araujo JB, Anon JM, Garcia de Lorenzo A, Garcia-Fernandez AM, Esparcia M, Adan J et al. (2017) Med intensive. https://doi.org/10.1016/j.medin.2017.05.005

  • Ayoub OM, Griffiths MV (2006) Aortic arch laceration: a lethal complication after percutaneous tracheostomy. Laryngoscope 117: 1–3

    Google Scholar 

  • Beiderlinden M, Adamzik M, Peters J (2005) Conservative treatment of tracheal injuries. Anesth Analg 100: 210–214

    Article  PubMed  Google Scholar 

  • Bhatti N, Mirski M, Tatlipinar A et al. (2007) Reduction of complication rate in percutaneous dilation tracheotomies. Laryngoscope 117: 172–175

    Article  PubMed  Google Scholar 

  • Byhahn CH, Westphal K, Meiniger D, Gürke B, Kessler P, Lischke V (2002) Single dilator percutaneous tracheostomy: a comparison of Percu Twist and Ciaglia Blue Rhino techniques. Intensive Care Med 28: 1262–1266

    Article  PubMed  Google Scholar 

  • Christenson TE, Artz GJ, Goldammer, JE, Spiegel JR, Boon MS (2008) Tracheal stenosis after placement of percutaneous dilational tracheotomy. Laryngoscope 118: 222–227

    Article  PubMed  Google Scholar 

  • Ciaglia P (1999) Technique, complications and improvements in percutaneous dilatational tracheostomy. Chest 115: 1229–1230

    Article  CAS  PubMed  Google Scholar 

  • Decker S, Gottlieb J, Cruz D, Müller CW, Wilhelmi M, Krettek C (2016) Percutaneous dilatational tracheostomy (PDT) in trauma patients: a safe procedure. Eur J Trauma Emerg Surg. 42 (5): 605–610

    Article  CAS  PubMed  Google Scholar 

  • Delaney A, Bagshaw SM, Nalos M (2006) Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis. Crit Care 10 (2): R55

    Article  PubMed  PubMed Central  Google Scholar 

  • Delank KW, Schmäl F, Stoll W (2002) HNO-ärztliche Erfahrungen mit traumatischen Läsionen der Tracheahinterwand. Laryngo-Rhino-Otol 81: 299–304

    Article  CAS  Google Scholar 

  • Dempsey GA, Grant CA, Jones TM (2010) Percutaneous tracheostomy: a 6 year prospective evaluation of the single tapered dilator technique. BJA 105 (6): 782–788

    Article  CAS  PubMed  Google Scholar 

  • Dempsey GA, Morton B, Hammell C, Williams LT, Smith CT, Jones T (2016) Longterm outcome following tracheostomy in critical care: A systematic review. Crit Care Med 44 (3): 617–628

    Article  PubMed  Google Scholar 

  • Deitmer TH, Delank K (1995) Kritische Anmerkungen aus HNO-ärztlicher Sicht zur perkutanen dilatativen Tracheotomie nach Ciaglia. Anaesthesiol Intensivmed Notfallmed Schmerzther 30: 501–503

    Article  CAS  Google Scholar 

  • Diaz-Reganon G, Minambres E, Ruiz A, Gonzales-Herrera S, Holanda-Pena M, Lopez-Espadas F (2008) Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients. Anaesthesia 63:1198–1203

    Article  CAS  PubMed  Google Scholar 

  • Dollner, R, Verch M, Schweiger P, Deluigi C, Graf B, Wallner F (2002) Laryngotracheoscopic findings in longterm follow-up after Griggs tracheostomy. Chest 122: 206–212

    Article  PubMed  Google Scholar 

  • Dongelmans DA, van der Lely AJ, Tepaske R, Schultz M (2004) Complications of percutaneous dilating tracheostomy. Crit Care 8: 397–398

    Article  PubMed  PubMed Central  Google Scholar 

  • Dost P, Koeser K (1999) Komplikationen der dilatativen Punktionstracheotomien in deutschen Hals-Nasen-Ohren-Abteilungen. Laryngo-Rhino-Otol 78: 81–85

    Article  CAS  Google Scholar 

  • Escarment J, Suppini A, Sallaberry M, Kaiser E et al. (2000) Percutaneous tracheostomy by forceps dilation: report of 162 cases. Anaesthesia 55: 125–130

    Article  CAS  PubMed  Google Scholar 

  • Fantoni A (2006) The need to compare different techniques of tracheostomy in a more reliable way. J An Ints 13: 61–64

    Google Scholar 

  • Fantoni A, Ripamonti D (1997) Eine nicht abgeleitete nicht-chirurgische Tracheotomie-Technik: Die translaryngeale Tracheotomie. Intensive Care Med 23: 386–392

    Article  CAS  PubMed  Google Scholar 

  • Fattahi T, Vega L, Fernandes R, Golman N, Steinberg B, Schare H (2012) Our experience with 171 open tracheotomies. J Oral Maxillofac Surg 70: 1699–1702

    Article  PubMed  Google Scholar 

  • Ferraro F, Marfella R, Esposito M, Petruzzi J, Torino A, Santini M, Fiorelli A (2015) Tracheal ring fracture secondary to percutaneous tracheostomy: is tracheal flaccidity a risk factor? J Cardiothorac Vasc Anaesth 29 (3): 560–564

    Article  Google Scholar 

  • Fikkers BG, Van Veen JA, Kooloos JG, Fickkers P, Van den Hoogen F et al. (2004) Emphysema andpneumothorax after percutaneous tracheostomy: case reports and anatomic study. Chest 125: 1805–1814

    Article  PubMed  Google Scholar 

  • Fiorini F, Santoro R, Deganello A, Mannelli G, Meccarariello G, Gallo O (2015) Is open tracheotomy performed by residents in otolaryngology a safe procedure? a retrospective cohort study. Eur Arch Otolaryngol 272: 1483–1489

    Article  Google Scholar 

  • Frova G, Quintel M (2002) A new simple method for percutaneous tracheostomy: controlled rotating dilation. Intensive Care Med 28: 299–303

    Article  CAS  PubMed  Google Scholar 

  • Gadkaree SK, Pandian V, Best S, Motz KM, Allen C, Kim Y, Akst L, Hillel AT (2017) Laryngotracheal Stenosis: Risk Factors for Tracheostomy Dependence and Dilation Interval. Otolaryngol Head Neck Surg 156(2): 321–328

    Google Scholar 

  • Gambale G, Cancellieri F, Baldini U, Vacchi Suzzi M, Baroncini S, Ferrari F, Petrini F (2003) Ciaglia percutaneous dilational tracheostomy: Early and late complications and follow-up. Minerva Anestesiologica 69: 825–833

    PubMed  CAS  Google Scholar 

  • Gomez-Caro A, Diez F, Herrero P, Gude V, Cabrero E, Porch E, Nicolas J (2005) Successful conservative management in iatrogenic tracheobronchial injury. Ann Thorax Surg 79: 1872–1878

    Article  Google Scholar 

  • Halum SL, Ting JY, Plowman EK, Belafsky PC, Harbarger CF, Postma GN, Pitman MJ et al. (2011) A multi-institutional analysis of tracheotomy complications. Laryngoscope 122: 38–45

    Article  Google Scholar 

  • Hashemian SM, Digaleh H (2015) A prospective randomized study comparing mini-surgical percutaneous dilatational tracheostomy with surgical and classic percutaneous tracheostomy. Medicine (Baltimore) 94 (47): e2015

    Article  Google Scholar 

  • Hazelton JP, Orfe EC, Calcino AM, Hunter K, Capano-Wehrle LM, Lachant MT et al. (2015) The impact of a multidisciplinary safety checklist on adverse procedural events during bedside bronchoscopy-guided percutaneous tracheostomy. J Trauma Acute Care Surg 79 (1): 111–116

    Article  PubMed  Google Scholar 

  • Heurn van LW, Goei R, de Ploeg I, Ramsay G, Brink PR (1996) Late complications of percutaneous dilatational tracheotomy. Chest 110: 1572–1576

    Article  Google Scholar 

  • Higgins D, Bunker N, Kinnear J (2009) Follow-up of patients with tracheal ring fractures secondary to antegrade percutaneous dilational tracheostomy. Eur J Anaesthesiol 26 (2): 147–149

    Article  PubMed  Google Scholar 

  • Hill B, Zweng T, Maley R, Charash W, Toursarkassian B, Kearny PA (1996) Percutaneous dilatational tracheostomy: report of 356 cases. J Trauma 41 (2): 238–244

    Article  CAS  PubMed  Google Scholar 

  • Jung HP, Henker M, Klemm E (2004) Langzeitergebnisse nach intercartilaginärer Visier-Tracheotomie. Mitteilungen Norddeutsche Gesellschaft für Otorhinolaryngologie und zervikofaziale Chirurgie. Demeter, S 43–46

    Google Scholar 

  • Kearny PA, Griffen MM, Ochoa JB, Boulanger BR, Tseui BJ, Mentzner RM (2000) A Single-center 8-year experience with percutaneous dilatational tracheostomy. Annals Surg 231 (5): 701–709

    Article  Google Scholar 

  • Kedjanyi WK, Gupta D (2001) Near total transection of the trachea following percutaneous dilatational tracheostomy. J R Coll Surg Edinb 46: 242–243

    PubMed  CAS  Google Scholar 

  • Klemm E (2006) Das Tracheotomie-Endoskop für Dilatationstracheotomien. Laryngo-Rhino-Otol 85: 628–832

    Article  Google Scholar 

  • Klemm E, Nowak A (2006) Das Tracheotomie-Endoskop für Dilatationstracheotomien (TED), erste Vorstellung eines neuen Verfahrens der HNO-Heilkunde und Intensivmedizin. J An Ints 13: 58

    Google Scholar 

  • Klemm E, Nowak A (2017) Tracheotomy-related death –a systematic review. Deutsch Arztebl Int 114: 273–279

    Google Scholar 

  • Klemm E, Petz R, Freigang B (1983) Der Gebissschaden, ein endoskopischer Unfall? HNO-Praxis 8: 295–300

    Google Scholar 

  • Klemm E, Künstle TH, Graf A, Henker M (1999) Tracheotomie, kritische Anmerkungen und Schlussfolgerungen. Intensivmed 36: 309–313

    Article  Google Scholar 

  • Klemm E, Henker M, Mürbe B (2000) Percutaneous and surgical tracheotomy: discussion of risks in various procedures. Laryngo-Rhino-Otol (Suppl 1) 79: 148

    Google Scholar 

  • Knipping S, Schmidt A, Bartel-Friedrich S (2016) Der Einsatz der perkutanen Dilatationstracheotomie im Rahmen der Kopf-Hals-Tumorchirurgie. Laryngorhinotologie 95 (1): 29–36

    CAS  Google Scholar 

  • Koitschev A, Graumüller S, Dommerich ST, Koitschev CH, Simon C (2003) Die Tracheotomie in der Intensivmedizin. Wird der HNO-Arzt noch gebraucht? HNO 51: 616–621

    CAS  Google Scholar 

  • Kost KM (2005) Endoscopic percutaneous dilatational tracheotomy: a prospective evaluation of 500 consecutive cases. Laryngoscope (Suppl) 115: 1–30

    Article  Google Scholar 

  • Law RA, Carney AS, Manara AR (1997) Long-term outcome after percutaneous dilatational tracheostomy. Anaesthesia 52: 51–56

    Article  CAS  PubMed  Google Scholar 

  • Leitlinie Tracheo-Bronchoskopie. AWMF online Register Nr. 017/061, Stand 07/2015. http://www.awmf.org/uploads/tx_szleitlinien/017-061l_S1_Tracheo_Bronchoskopie_2015-07.pdf

  • Lopez-Pastorini A, Kraja O, Ludwig C, Plönes T, Storre JH, Rommel T, Riecker A, Stoelben E (2015) Reduktion Tracheostoma-assoziierter Trachealstenosen durch chirurgischen Stomaverschluss. Pneumologie 69: 335–340

    Article  CAS  PubMed  Google Scholar 

  • Massick D, Yao S, Powell D et al. (2001) Bedside tracheostomy in the intensive care unit: a prospective randomized trial comparing surgical tracheostomy with endoscopically percutanous dilational tracheotomy. Laryngoscope 111: 494–500

    Article  CAS  PubMed  Google Scholar 

  • McCague A, Aljanabi H, Wong DT (2012) Safety analysis of percutaneous dilatational tracheostomies with bronchoscopy in the obese patient. Laryngoscope 122: 1031–1034

    Article  PubMed  Google Scholar 

  • Muhammad JK, Major E, Wood A, Patton D (2000) Percutaneous dilatational tracheostomy: haemorrhagic complication and the vascular anatomy of the anterior neck. A review on 497 cases. Int J Oral Maxillofac Surg 29: 217–222

    Article  CAS  PubMed  Google Scholar 

  • Nicolli EA, Carey RM, Farquhar D, Haft S, Alfonso KP, Mirza N (2017) Risk factors for adult acquired subglottic stenosis. JLO 131: 264–267

    Article  CAS  Google Scholar 

  • Norwood S, Vallina V, Short K, Saigusa M, Fernandez L, Mc Larty J (2000) Incidence of tracheal stenosis and other late complications after percutaneous tracheostomy. Ann Surg 232: 233–241

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nowak A, Klemm E (2011) Percutaneous dilatational tracheotomy using the tracheotomy endoscope. Laryngoscope 121: 1490–1494

    Article  PubMed  Google Scholar 

  • Nowak A, Klemm E, Rothe KF (2007) Use of a tracheotomy-endoscope for percutaneous dilatational tracheostomy, results of a pilot study. Anesthesiology 107: A961

    Google Scholar 

  • Nowak A, Kern P, Koscielny S, Usichenko TI, Hahnenkamp A, Jungehülsing M, Tittel M, Oeken J, Klemm E (2017) Feasibility and safety of dilatational tracheotomy using the rigid endoscope: a multicenter study. BMC Anesthesiol 17 (1): 7. https://doi.org/10.1186/s12871-017-0301-y

    Article  PubMed  PubMed Central  Google Scholar 

  • Oeken J, Adam H, Bootz F (2002) Translaryngeale Tracheotomie (TLT) nach Fantoni mit starrer endoskopischer Kontrolle. HNO 50: 638–643

    Article  CAS  PubMed  Google Scholar 

  • Oggiano M, Ewig S, Hecker E (2014) A comparison of percutaneous dilatational tracheostomy versus conventional surgical tracheostomy. Retrospective study in 378 patients 2003–2008. Pneumologie 68: 322–328

    Article  CAS  PubMed  Google Scholar 

  • Oreadi D, Carlson ER (2012) Morbidity and mortality associated with tracheotomy procedure in a university medical centre. Int J Oral Maxillofac Surg 41: 974–977

    Article  CAS  PubMed  Google Scholar 

  • Paez M, Buisan F, Almaraz A, Martinez-Martinez A, Munoz F (2005) Percutaneous tracheotomy with the Ciaglia Blue Rhino technique: a critical analysis after 1 year. Rev Esp Anestesiol Reanim 52 (8): 466–73

    PubMed  CAS  Google Scholar 

  • Pilarczyk K, Haake N, Dudasova M, Huschens B, Wendt D, Demircioglu E, Jakob H, Dusse F (2016) Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis. Anaesth Intensive Care 44: 227–236

    PubMed  CAS  Google Scholar 

  • Remacle M, Lawson G, Jamart J, Trussart C, Bulpa P (2008) Comparison between the Percutwist® and the Ciaglia® percutaneous tracheotomy techniques. Eur Arch Otorhinolaryngol 265: 1515–1519

    Article  PubMed  Google Scholar 

  • Rieger A (2006) Tracheotomie unter Einsatz der Intubationslarynxmaske. J An Ints 13: 51–54

    Google Scholar 

  • Rosenbower T, Morris J, Eddy V, Ries W (1998) The long-term complications of percutaneous dilatational tracheostomy. Am Surg 64: 82–86

    PubMed  CAS  Google Scholar 

  • Shlugman D, Satya-Krishna R, Loh R (2003) Acute fatal haemorrhage during percutaneous dilatational tracheostomy. BJA 90: 517–520

    Article  CAS  PubMed  Google Scholar 

  • Straetmans J, Schlöndorff G, Herzhoff G, Windfuhr JP, Kremer B (2010) Complications of midline-open tracheotomy in adults. Laryngoscope 120: 84–92

    Article  PubMed  Google Scholar 

  • Terragni PP, Antonelli M, Fumagalli R et al. (2010) Early vs late tracheotomy for prevention of pneumonia in mechanically ventilated adult ICU patients: a randomized controlled trial. JAMA 303 (15): 1483–1489

    Article  CAS  PubMed  Google Scholar 

  • Trottier SJ, Hazard PB, Sakabu SA et al. (1999) Posterior tracheal wall perforation during percutaneous dilational tracheostomy: an investigation into its mechanism and prevention. Chest 115: 1383–1389

    Article  CAS  PubMed  Google Scholar 

  • Trouillet JL, Luyt CE, Guiguet M, Quattara A, Vaissier E, Makri R et al. (2011) Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery. Ann Intern Med 154: 373–383

    Article  PubMed  Google Scholar 

  • Walz MK, Peitken K, Thürauf N, Trost HA, Wolfhard U, Sander A, Ahmadi C, Eigler FW (1998) Percutaneous dilatational tracheostomy-early results and long-term outcome of 326 critically ill patients. Intensive Care Med 24: 685–690

    Article  CAS  PubMed  Google Scholar 

  • Walz MK, Schmidt U (1999) Tracheal lesion caused by percutaneous dilatational tracheostomy – a clinico-pathological study. Intensive Care Med 25: 102–105

    Article  CAS  PubMed  Google Scholar 

  • Young E, Pugh R, Hanlon R, O’Callaghans E, Wright C, Jeanrenaud P, Jones TM, Dempsey GA (2014) Trachealstenosis following percutaneos dilatational tracheostomy using the single tapered dilator: an MRI study. Anaesth Intensive Care 42 (6): 745–751

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, Städtisches Klinikum, Friedrichstraße 41, D-01067, Dresden, Deutschland

    E. Klemm

  2. Klinik für Anästhesiologie und Intensivmedizin, Notfallmedizin und Schmerztherapie, Städtisches Klinikum, Friedrichstraße 41, D-01067, Dresden, Deutschland

    A. Nowak

Authors
  1. E. Klemm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Nowak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Klemm .

Editor information

Editors and Affiliations

  1. Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, Städtisches Klinikum, Dresden, Germany

    Eckart Klemm

  2. Klinik für Anästhesiologie und Intensivmedizin, Notfallmedizin und Schmerztherapie, Städtisches Klinikum, Dresden, Germany

    Andreas Nowak

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Klemm, E., Nowak, A. (2018). Komplikationen der Tracheotomie und Strategien zu deren Vermeidung. In: Klemm, E., Nowak, A. (eds) Kompendium Tracheotomie und Atemwege . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56824-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-56824-8_10

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56823-1

  • Online ISBN: 978-3-662-56824-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation