False tract during tracheostomy tube insertion: a review
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20263404Keywords:
Tracheostomy, False tract, Complication, Airway management, Tracheostomy tube insertionAbstract
Tracheostomy a surgical intervention, emergency or elective in non-ambulatory and upper airway compromised individuals. The utility of this procedure is twofold i.e. tracheo -bronchial toilet in the former and mechanical ventilation by bypassing the upper respiratory tract, in the latter. The simple surgery is sometimes fraught with unexpected complications and consequent significant morbidity and mortality. The likelihood is more so in the pediatric age group, where the trachea is pencil thin almost equal vent to the carotids in its diameter. Incorrect insertion of tracheostomy tube with, a consequent false tract and thereby a mal - positioned ventilation circuit, is a malady with likelihood of untoward consequences and thereby significant morbidity and mortality. This review highlights the utility of appropriate technique, early recognition, and remedial interventions in these false tracheostomy tracts. The etiology, diagnosis, complications and medical or surgical management with recent advances in prevention and treatment strategies shall be emphasized upon.
References
Umstot R, Samantha D, Umstot E, Area SA, Richmond BK, Jarrouj A. Ten-year review of tracheostomy techniques and related complications. The American Surgeon™. 2024;90 2):225-30.
Pershad AR, Peña M, Zalzal H, Pena M. Reducing the Morbidity Associated with Incorrect Pediatric Tracheostomy Tube Placement: A Quality Improvement Initiative. Cureus. 2025;17(4):e81619.
Rajajee V, Fletcher JJ, Rochlen LR, Jacobs TL. Real-time ultrasound-guided percutaneous dilatational tracheostomy: a feasibility study. Crit Care. 2011;15(1):R67.
Singh S, Herth FJ, Shah PL, Gompelman D. Bronchoscopy in intensive care. Interventional pulmonology European Respiratory Monogram. Europ Respiratory J. 2017;29-48.
Dempsey GA, Morton B, Hammell C, Williams LT, Smith CT, Jones T. Long-term outcome following tracheostomy in critical care: a systematic review. Crit Care Med. 2016;44 3):617-28.
Lubianca JF, Castagno OC, Schuster AK. Complications of tracheostomy in children: a systematic review. Braz J Otorhinolaryngol. 2022;88 6):882-90.
Lin KT, Kao YS, Chiu CW, Lin CH, Chou CC, Hsieh PY, et al. Comparative effectiveness of ultrasound-guided and anatomic landmark percutaneous dilatational tracheostomy: A systematic review and meta-analysis. PLoS One. 2021;16 10):e0258972.
Ji Y, Fang Y, Cheng B, Li L, Fang X. Tracheostomy timing and clinical outcomes in ventilated COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2022;26 1):40.
Ferro A, Kotecha S, Auzinger G, Yeung E, Fan K. Systematic review and meta-analysis of tracheostomy outcomes in COVID-19 patients. Brit J Oral Maxillofac Surg. 2021;59 9):1013-23.
Ren B, Bao Y, Lin H, Tang B, Chen B, Zhang K. Ultrasound-guided percutaneous dilatational tracheostomy versus landmark- and bronchoscopy-guided techniques in critically ill patients: a systematic review and meta-analysis of randomized controlled trials. Front Med Lausanne). 2026;13:1818411.
Romero CM, Cornejo R, Tobar E, Gálvez R, Luengo C, Estuardo N, et al. Fiber optic bronchoscopy-assisted percutaneous tracheostomy: a decade of experience at a university hospital. Revista Brasileira de Terapia Intensiva. 2015;27(2):119-24.
Bharadwaj S, Kamath S. Airway management in neuroanesthesia. The Airway Manual: Practical Approach to Airway Management. 2023;571-91.
Andrabi B, Naqvi SM, Rehman SU. Navigating Airway Management in Post-tracheostomy Patients: A Case Report and Review of the Literature. Cureus. 2025;17(9):e92996.
Ahmed Ha, Naglaa M, Ahmed Ye, Mohamed Wa. Ultrasound guided percutaneous tracheostomy versus conventional tracheostomy: Technique and outcome. Med J Cairo University. 2021;89(9):1669-78.
Rana S, Pendem S, Pogodzinski MS, Hubmayr RD, Gajic O. Tracheostomy in critically ill patients. In Mayo Clinic Proceedings. Elsevier. 2005;80(12):1632-8.
Singh S, Herth FJ, Shah PL, Gompelman D. Bronchoscopy in intensive care. Interventional pulmonology European Respiratory Monogram. Europ Respiratory J. 2017;29-48.
Windsor HM, Shanahan MX, Cherian K, Chang VP. Tracheal Injury Following Prolonged Intubation 1. Aust N Zeal J Surg. 1976;46(1):18-25.
Durbin Jr CG. Early complications of tracheostomy. Respiratory Care. 2005;50 4):511-5.
Marelli D, Paul A, Manolidis S, Walsh G, Odim JN, Burdon TA, et al. Endoscopic guided percutaneous tracheostomy: early results of a consecutive trial. J Trauma Acute Care Surg. 1990;30 4):433-5.
McGuire G, El-Beheiry H, Brown D. Loss of the airway during tracheostomy: rescue oxygenation and re-establishment of the airway. Canad J Anesth. 2001;48(7):697-700.
Addas BM, Howes WJ, Hung OR. Light-guided tracheal puncture for percutaneous tracheostomy. Canad J Anaesthesia. 2000;47(9):919-22.
Agrò F, Salvinelli F, Gherardi S, Casale M. The lightwand: a useful aid in the difficult tracheostomy. Canad J Anesthesia. 2002;49(9):1000-1.
Ojo A. Complications after tracheostomy: literature review Doctoral dissertation, Vilniaus Universitetas. 2025.
Wen D, Yang X, Liang Z, Hu Y, Wang S, Zhang D, et al. Effectiveness of ultrasound-guided versus anatomical landmark-guided percutaneous dilatational tracheostomy: a systematic review and meta-analysis. BMC Anesthesiol. 2025;25(1):211.
Kaur N, Lewis S, Jenkinson H, Keegan C, Misra N, Neequaye S, et al. Management of major thoracic trauma: a narrative review. Anaesthesia. 2026.
Ji Y, Fang Y, Cheng B, Li L, Fang X. Tracheostomy timing and clinical outcomes in ventilated COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2022;26(1):40.
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Copyright (c) 2026 Manish Munjal, Jaspinder K. Dhillon, Shubham Munjal, Anjali Tyagi, Parunithi, Rohit, Susan, Shivendu, Diksha Goyal, Geetanjili, Biven
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