Infection
Secretions are normal in patients with tracheostomies, but when they become bloody or abnormally thick and change color, this may indicate either trauma or infection in the airway. Hospitals will obtain a specimen and send it for culture and sensitivity analysis.
Infection is rare in the immediate postoperative period, but in the long term tracheal infections are common. Patients are often found colonized with Gram negative bacilli. Patients who are receiving positive pressure ventilation may acquire bacterial pneumonia, tracheobronchitis, Clostridium difficile, line infection or urosepsis. Identifying the organism in pneumonia is difficult as these patients frequently have airway colonization. A study with 14 patients revealed evidence of greater than 10,000 colony-forming units of bacteria in 29 of 32 lobes sampled. (14) In general, infection is common because patients with a tracheostomy tube often have a compromised immune system and lack the natural defense of the cilia and cough reflex, which are the natural defense to prevent respiratory infections. | | | | |
