Predicting postoperative tracheostomy requirement in children undergoing surgery for posterior fossa tumors

Goethe, Eric A.; LoPresti, Melissa A.; Gadgil, Nisha; Lam, Sandi

doi:10.1007/s00381-020-04605-7

Cited by 3 publications

(9 citation statements)

References 22 publications

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“…Our results show a remarkably high frequency of tracheostomies in patients whose GR was absent or brainstem was invaded, either compressed or in ltrated by the MB tumors. We found the incidence of tracheostomy requirement in our center for children undergoing MB tumor resection to be 26%, which is relatively high compared to previous studies (1.5%, 16%, and 6.4%) [4][5][6].…”

Section: Discussioncontrasting

confidence: 56%

“…However, one-fourth of the patients with absent GR pre-operatively did not require tracheostomy after the operation. It is worth considering that in previous studies, 25% or more of the patients were decannulated one year after the tracheostomy [4,5]. Moreover, once the course of tracheostomy is nished, a second tracheostomy is rarely needed.…”

Section: Discussionmentioning

confidence: 99%

“…The aim of the present study was to identify pre-and post-operative clinical and radiological factors associated with tracheostomy requirement in children with MB who underwent surgical resection. In the study by Goethe et al, having postoperative dysphagia, ependymoma or astrocytoma (as opposed to MB and atypical teratoid/rhabdoid tumor), and being younger were found to be linked to tracheostomy requirement in children undergoing surgery for posterior fossa tumors [4].…”

Section: Introductionmentioning

confidence: 96%

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Predictive Factors for Postoperative Tracheostomy Requirement in Children Undergoing Surgical Resection of Medulloblastoma

2021

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Purpose: Medulloblastoma is the most common pediatric malignancy. Postoperative respiratory failure is an important complication in post-operative recovery of patients undergoing medulloblastoma resection. We aimed to identify factors predicting tracheostomy requirement in children post-operatively.Methods: Retrospective chart review of all patients under 18 undergoing medulloblastoma resection from 2012 to 2020 at Namazi hospital was conducted.Results: 45 patients (26%) needed tracheostomy after the operation. The most common indications were brainstem compression and absence of gag re ex prior to operation. Patients who had brainstem compression and in ltration by medulloblastoma, bilateral absence of gag re ex prior to operation, subtotal resection of tumor, and post-operative brainstem contusion were more likely to require tracheostomy. No statistically signi cant difference was observed between males and females and different ages. Conclusion:The results show that if we prevent the invasion of the brainstem by the tumor and resect the tumors totally and accurately, tracheostomy, a highly costly and stressful post-operative complication can be prevented.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Predictive Factors for Postoperative Tracheostomy Requirement in Children Undergoing Surgical Resection of Medulloblastoma

2021

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“…Accidental decannulation, stoma infection, bleeding, subcutaneous emphysema, granulation, tracheocutaneous fistula, fistula to the innominate artery, tearing of posterior tracheal wall, subglottic stenosis, pneumothorax, fatal or nearly-fatal tube obstruction, and pneumonia are among the complications cited. 14 , 17 , 18 , 22 , 31 , 37 , 38 Deaths directly related to tracheostomy are rarely reported, ranging from 0.6 to 14.4%, due to massive bleeding 21 and cannula obstruction. 17 , 23 , 39 , 40 Underlying cardiopulmonary disease and premature birth are factors associated with increased mortality in pediatric tracheostomy patients under 2 years of age.…”

Section: Resultsmentioning

confidence: 99%

“… 13 Other authors reported rates of successful decannulation varying from 12.6% to 77.8%, after median times from 123 days to 38 months. 14 , 16 , 19 , 22 , 32 , 37 , 38…”

Section: Resultsmentioning

confidence: 99%

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Araújo

Azevedo

Oliveira

et al. 2022

Jornal de Pediatria

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Incidence and Perioperative Risk Factors of Delayed Extubation following Pediatric Craniotomy for Intracranial Tumor: A 10-Year Retrospective Analysis in a Thailand Hospital

Sangtongjaraskul

Yuwapattanawong

Sae-phua

et al. 2022

J Neuroanaesth Crit Care

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Background The determination of extubation (early or delayed) after pediatric craniotomy for intracranial tumor should be carefully considered because each has its pros and cons. The aim of this study was to investigate the incidence of the delayed extubation in these patients. The secondary goal was to identify the perioperative factors influencing the determination of delayed extubation. Methods This retrospective study was performed in pediatric patients with intracranial tumor who underwent craniotomy at a university hospital between April 2010 and March 2020. Preoperative and intraoperative variables were examined. The variables were compared between the delayed extubation and early extubation group. Results Forty-two of 286 pediatric patients were in the delayed extubation group with an incidence of 14.69%. According to multivariate analyses, the risk factors that prompted delayed extubation were the intracranial tumor size ≥ 55 mm (adjusted odds ratio [AOR], 2.338; 95% confidence interval [CI], 1.032–5.295; p = 0.042), estimated blood loss (EBL) ≥ 40% of calculated blood volume (AOR, 11.959; 95% CI, 3.457–41.377; p < 0.001), blood transfusion (AOR, 3.093; 95% CI, 1.069–8.951; p = 0.037), duration of surgery ≥ 300 minutes (AOR, 2.593; 95% CI, 1.099–6.120; p = 0.030), and completion of the operation after working hours (AOR, 13.832; 95% CI, 2.997–63.835; p = 0.001). Conclusions The incidence of delayed extubation after pediatric craniotomy was 14.69%. The predictive factors were the size of tumor ≥ 55 mm, EBL ≥ 40% of calculated blood volume, blood transfusion, duration of surgery ≥ 300 minutes, and completion of surgery after routine working hours.

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Predicting postoperative tracheostomy requirement in children undergoing surgery for posterior fossa tumors

Cited by 3 publications

References 22 publications

Predictive Factors for Postoperative Tracheostomy Requirement in Children Undergoing Surgical Resection of Medulloblastoma

Predictive Factors for Postoperative Tracheostomy Requirement in Children Undergoing Surgical Resection of Medulloblastoma

Tracheostomy practices in children on mechanical ventilation: a systematic review and meta-analysis

Incidence and Perioperative Risk Factors of Delayed Extubation following Pediatric Craniotomy for Intracranial Tumor: A 10-Year Retrospective Analysis in a Thailand Hospital

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