Hemorrhage, ordinarily a more bothersome than dangerous complication of tracheotomy, usually starts shortly after the surgical procedure and consists primarily of steady oozing from venous tributaries. Even when the bleeding begins days after tracheotomy, it is not customarily serious. Delayed blood loss may result from infection or trauma to the tissues surrounding the operative site, from mechanical or infectious tracheitis, premature separation of diphtheric membranes, or disease of the lower respiratory tract.
The possibility that delayed hemorrhage after tracheotomy may be fatal is emphasized in a recent issue of the Archives of Internal Medicine.1 Two cases are described in which death occurred three and six days after successful tracheotomy. In both patients the hemorrhage resulted from pressure-induced erosion of the cannula through the tracheal wall into an adjacent mediastinal artery. As a consequence, blood loss was fulminating and the patients were rapidly exsanguinated or suffocated.
Bleeding from the tracheotomy
HEMORRHAGE COMPLICATING TRACHEOTOMY. JAMA. 1965;193(5):388-389. doi:10.1001/jama.1965.03090050064019