Percutaneous tracheostomy can be performed safely, but certain conditions may increase the risk of complications. Greater care should be exercised if any of these risk factors are present.
Risk factors for complications:
(1) severe to morbid obesity
(2) repeated tracheostomy
(3) high end expiratory pressure
(4) severe coagulopathy
(5) unusual neck anatomy
(6) previous trauma or surgery to the neck
(7) marked patient coughing, agitation or lack of cooperation
(8) emergency procedure
(9) operator inexperience
(10) impaired host defense (immunodeficiency, immunosuppression, neutropenia, etc.)
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