 Complications may also be severe and long @-@ lasting or permanent , such as vocal cord damage , esophageal perforation and retropharyngeal abscess , bronchial intubation , or nerve injury . They may even be immediately life @-@ threatening , such as laryngospasm and negative pressure pulmonary edema ( fluid in the lungs ) , aspiration , unrecognized esophageal intubation , or accidental disconnection or dislodgement of the tracheal tube . Potentially fatal complications more often associated with prolonged intubation and / or tracheotomy include abnormal communication between the trachea and nearby structures such as the innominate artery ( tracheoinnominate fistula ) or esophagus ( tracheoesophageal fistula ) . Other significant complications include airway obstruction due to loss of tracheal rigidity , ventilator @-@ associated pneumonia and narrowing of the glottis or trachea . The cuff pressure is monitored carefully in order to avoid complications from over @-@ inflation , many of which can be traced to excessive cuff pressure restricting the blood supply to the tracheal mucosa . A 2000 Spanish study of bedside percutaneous tracheotomy reported overall complication rates of 10 – 15 % and procedural mortality of 0 % , which is comparable to those of other series reported in the literature from the Netherlands and the United States . 
