Physiological changes that occur with a tracheostomy

As well as changing the airway anatomy, the airway physiology is altered when a patient has a tracheostomy inserted. Depending on the type of tube and presence of a cuff, the upper airway may be isolated completely.

The tracheostomy will generally remain until the indication for insertion has resolved. In some instances however, the tracheostomy will be permanent. A laryngectomy is a permanent surgical change to the airway anatomy.

With a tracheostomy in place, air bypasses the nose. The nose plays an important role in warming and humidifying air that passes to the lungs. This can cause dryness and can lead to thick secretions in the lungs.

As air is bypassing the nose, smell and taste are often impaired.

This video explains in detail the physiological changes that occur when a tracheostomy tube is in place and the subsequent complications that can occur.

Secretions are a natural reaction to a tracheostomy, not a sign there is an issue. A tracheostomy tube bypasses the upper airway, which is responsible for filtering, warming and humidifying the air we breathe. This causes the body to produce thick secretions, making the patient at risk of plugging their tracheostomy tube.