Pediatric Tracheostomy at a Tertiary Healthcare Institution: A Retrospective Study Focused on Outcomes

Abstract

The aim of this study was to retrospectively evaluate all pediatric tracheotomies that had been performed at Sanliurfa Training and Research Hospital From September 2016 to July 2019. A retrospective study was performed on pediatric patients who had undergone tracheostomy during the three-year study period. Patient data were reviewed for the following variables: age, gender, age at the time of tracheostomy, primary indication for tracheostomy, length of stay in intensive care unit before and after tracheostomy, complications, mortality and cause of death. The primary indication for tracheostomy was categorized into 4 separate groups: congenital disease, traumatic injury, prolonged intubation and other causes. The study group consisted of 138 children. Seventy-one (51.4%) of the children were male, 67 (48.6%) were female and the mean age of tracheostomy was 13.30 (0.03–192.27) months, and 44.2% were younger than 1 year when tracheotomy was performed. The median age at the time of tracheostomy was highest in children who underwent tracheostomy for traumatic injury. The indication for tracheostomy was prolonged intubation in 73.2% of the children. Complications were observed in 13 (9%) children; bleeding (69.2%) was the most common. Complications were most frequent in children who underwent tracheostomy for prolonged intubation. The overall mortality ratewas 30.4% with cardiac arrest being the most common cause. At our center, the most common indication for tracheostomy in children was long-term intubation, possibly due to our center being a tertiary healthcare institute. Bleeding was the most common complication, while cardiac arrest was the most common cause of death.

Unraveling the Evolving Trends of Pediatric Tracheostomy- An Overview at a Tertiary Care Center

“…Alladi., et al The decannulation period varied from 2 days to 4 months and they too have witnessed a similar change in the indications [7]. We, in our study were able to successfully decannulate 98% of our patients, we primarily faced difficulty due to ventilator acquired pneumonia and thick secretions which delayed the decannulation as well as poor general condition, due to respiratory muscle weakness as seen in GB syndromes making the child a candidate for prolonged tracheostomy [9]. Two cases of subglottic stenosis and tracheal stenosis and underwent LASER for the same, after which they were decannulated.…”

“…Several studies regarding pediatric tracheostomies have been conducted at centres for pediatric surgery or paediatric cardiac surgery, these children already have poor general conditions and hence are invariably candidates for prolonged tracheostomy [19,20] so the data regarding the mortality following tracheostomy cannot be extrapolated to centres elsewhere receiving a more varied variety of cases such as ours [21]. Mortality among the patients in our study was just 3% mainly due to respiratory failure or cardiorespiratory arrest and it too must be considered while planning the course of management in tracheostomized patients [22,23].…”