Tube Dislodgement and Loss of Airway
Another potentially deadly complication is tube displacement during the early postoperative period before the stoma has healed. Tubes can be displaced completely (decannulation) or partially (dislodgement) when the tip of the tube lies within a false passage anterior to the trachea (Figure 3). Predisposing factors include loose ties, edema of the neck, airway edema, excessive coughing, agitation, undersedation, morbid obesity, a tracheostomy tube that is too short for the tract, the technique used to place the tracheostomy tube, and downward traction caused by the weight of the ventilator circuit.40,43,44