Evaluation of tracheostomy patients in a pediatric cardiac intensive care unit: our five-year single-center experiences

Saygı, Murat; Özden, Ömer; Öztürk, Erkut; Yıldız, Okan; Haydın, Sertaç; Yeniterzi, Mehmet; Ergül, Yakup; Güzeltaş, Alper; Bakır, İhsan

doi:10.5606/tgkdc.dergisi.2016.12172

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Authors concluded that early tracheostomy did not improve important clinical outcomes [21]. On the other hand, some authors suggest that tracheostomy may shorten the ICU length of stay, however, does not shorten the total length of in-hospital stay [27,28]. Additionally, Garcia-Urabayen et al [29] conducted a retrospective study and analyzed the outcomes of tracheostomies in a Paediatric ICU during the period 2003-2013, including 25 patients in Spain, concluded that the post-operative course of a tracheotomy is associated with a higher rate of complications and mortality.…”

Section: Discussionmentioning

confidence: 99%

Does Tracheostomy Affect the Mortality and Morbidity Rate After Cardiac Surgery?

Deşer¹

2018

J Clin Exp Invest

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This retrospective study aims to investigate the timing and outcomes of tracheostomy, mortality and morbidity rates, length of in-hospital and cardiovascular intensive care unit (ICU) stay in patients with post-cardiac surgery. Patients and Methods: Between October 2014 and October 2016, a total of 401 cardiac surgery were performed in our hospital. Thirteen patients who needed post-operative prolong ventilation (7 female; 6 male; mean age was 67.7 ± 9.8 years; range 47 to 86 years) undergoing tracheostomy procedure, were included in this retrospective study. Results: The mean intubation time between the cardiac surgery and tracheostomy was 14.5±2.9 days (range 11 to 21). The mean intensive care unit stay time was 27.4 ±9.4 days (range 12 to 49) and the mean in-hospital stay was 43.1±23.7 days (range 16-91). 8 patients passed away and the in-hospital mortality rate was 61%. After a mean follow-up of 161.4±151.1 days (range 57 to 417), 3 patients (7%) passed away while one patient (7%) was decannulated. One patient (7%) is currently under follow-up at home using a home-type ventilator. Regarding patients who passed away after discharge, the overall mortality rate was 84.6%. In addition, the number of extubation attempts was 0.65±1.12 (range 0 to 4). Conclusion: Tracheostomy is performed in need of prolonged mechanical ventilation in patients with post cardiac surgery. We thought that tracheostomy does not decrease the incidence of nosocomial pneumonia in hospital/ICU stay and morbidity/mortality as expected.

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Section: Discussionmentioning

confidence: 99%

Does Tracheostomy Affect the Mortality and Morbidity Rate After Cardiac Surgery?

Deşer¹

2018

J Clin Exp Invest

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“…18,19 Saygı ve ark., pediatrik kardiyak cerrahi uygulanan 1.450 hastada trakeotomi gereken hasta sayısını 18 olarak bildirmişlerdir. 20 Hastaların ortalama ağırlığı 5,8±2,9 kg, trakeotomi öncesi ortalama entübasyon süreleri ise 41±12,9 gün olarak bildirilmiştir. Bu çalışmadaki toplam mortalite oranı %38,8 olup, trakeotomi ile ilişkili mortalite izlenmemiştir.…”

Section: Gereç Ve Yöntemlerunclassified

“…Bununla birlikte, hastaya ait birtakım faktörler nedeni ile bu sürede uzama yaşanabilmektedir. 20 Kırk altı hastayı içeren bir başka çalışmada ise ortalama ağırlık 4,7 kg ve trakeostomi öncesi entübasyon süresi ortalama 58 gün olarak bildirilmiştir. Bu çalışmada, ölümlerin 5 (%10,86)'inin trakeotomi tüpünün çıkması ya da tıkanmasına bağlı gerçekleştiği bildirilmektedir.…”

Section: Gereç Ve Yöntemlerunclassified

Pediatric Tracheotomy: A Single Center Pediatric Cardiac Intensive Care Unit Experience

Akdoğan¹,

Gökdemir²,

Cındık³

et al. 2019

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Bu çalışmada, hastanemizde gerçekleştirilmiş olan pediatrik trakeotomilerin retrospektif analizi sağlanarak elde edilen bulguların literatürle karşılaştırılması ve olası benzer ve farklı yönlerin ortaya konması hedeflenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Başkent Üniversitesi Konya Eğitim ve Araştırma Merkezi'nde Ocak 2015-Mayıs 2019 tarihleri arasında gerçekleştirilmiş olan pediatrik trakeotomiler retrospektif olarak incelenmiştir. Hastane bilgi sisteminden, trakeotomi açılan 16 yaş altı tüm hastalar tespit edilmiş; hastaların trakeotomi açılma endikasyonları, entübasyon süreleri, trakeotominin açıldığı dönemdeki yaş ve kiloları, karşılaşılan komplikasyonlar, mortalite ve dekanülasyon durumları incelenmiştir. B Bu ul lg gu ul la ar r: : Toplam 35 hastaya trakeotomi açıldığı tespit edildi. Tüm hastalara standart trakeotomi prosedürü uygulandı. Hastaların 15 (%42,9)'i erkek, 20 (%57,1)'si ise kız idi. Hastaların %60 (n=21)'ında geçirilmiş kardiyak cerrahi söz konusuydu. Ortalama yaş 13 ay (1-90 ay) idi. Hastaların %77 (n=27)'si bir yaş altındaydı. Bu oran, kardiyak cerrahi geçiren grupta %80,9 idi. İşlem sırasında hastaların ortalama kiloları 6,192 gram idi. En sık trakeotomi endikasyonu nörolojik nedenlere bağlı olup (14 hasta; %40), bunu sırasıyla uzamış entübasyon (11 hasta; %31,4) ve üst hava yolu obstrüksiyonu (10 hasta; %28,6) takip etmekteydi. İki (%5,7) hastada majör komplikasyon izlenirken, trakeotomiye bağlı mortalite 1 (%2,8) hastada ortaya çıktı. S So on nu uç ç: : Pediatrik trakeotomi işlemi, özellikle son yıllarda pediatrik yoğun bakım hizmetlerindeki gelişmelerle daha sık ihtiyaç duyulan özellikli bir cerrahidir. Bu çalışmada, hastalarımızda en sık trakeotomi endikasyonunun nörolojik nedenlere bağlı olduğu, kardiyak cerrahi geçiren hastalarda ise uzamış entübasyon ve üst havayolu tıkanıklığının etiyolojide yer aldığı tespit edilmiştir. Majör komplikasyon ve mortalite oranlarımız kabul edilebilir sınırlarda iken dekanülasyon oranlarımızın düşük olduğu görülmüştür.

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The Outcomes of Tracheostomy in Pediatric Cardiac Surgical Patients

Sahu

Bipin

Dhatterwal

et al. 2021

Journal of Cardiac Critical Care TSS

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Objectives To describe the outcomes of postoperative tracheostomy and determine the predictors of survival. Design Prospective, observational study. Setting Cardiac surgical intensive care unit of a tertiary care hospital. Participants All pediatric patients below 10 years of age who underwent tracheostomy after cardiac surgery from January 2019 to December 2019. Different variables were compared between survivors and nonsurvivors. Intervention Tracheostomy. Results Among 1084 pediatric patients who underwent cardiac surgery during the study period, 41 (3.7%) received tracheostomy. Survival rate was 71%.Earlier, sternal closure (SC) (p = 0.04), acute kidney injury (AKI) (p = 0.001), serum C-reactive protein (CRP) (p = 0.007), duration of total parenteral nutrition (TPN) (p = 0.005) and days of feed interruption (FI) (p = 0.02), activated partial thromboplastin time (aPTT) before tracheostomy (p = 0.006), and bleeding from tracheostomy site (p = 0.02) were significantly low in the survivor group.Among the peritracheostomy variables taken at different time points, the levels of pH on tracheostomy day 1 (p = 0.03), serum lactate on tracheostomy day 2 (p = 0.01) and day 3 (p = 0.01), and random blood sugar (RBS) on tracheostomy day 3 (p = 0.04) were significantly lower in the survivor group.The arterial oxygen saturation (SaO2) on tracheostomy day 1 (p = 0.04) and the platelet count before tracheostomy (p = 0.02) were significantly higher in the survivor group. Conclusions Our study demonstrated a survival of 71% among the study cohort. Lesser duration of open sternum, lower incidence of AKI, less number of days on TPN and FI, lower posttracheostomy aPTT, bleeding, RBS, lactate, and higher pretracheostomy platelet count and posttracheostomy SaO2 were found to be the predictors of survival.

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Evaluation of tracheostomy patients in a pediatric cardiac intensive care unit: our five-year single-center experiences

Cited by 3 publications

References 13 publications

Does Tracheostomy Affect the Mortality and Morbidity Rate After Cardiac Surgery?

Does Tracheostomy Affect the Mortality and Morbidity Rate After Cardiac Surgery?

Pediatric Tracheotomy: A Single Center Pediatric Cardiac Intensive Care Unit Experience

The Outcomes of Tracheostomy in Pediatric Cardiac Surgical Patients

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