Study of indications and complications of tracheostomy in pediatric age group

Sheth, Rakesh; Chaudhari, Chintu C.; Damaniya, Virag; Goyani, Bhavesh; Aiyer, R. G.

doi:10.5455/ijmsph.2016.19102015132

Cited by 2 publications

(1 citation statement)

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“… 16 – 18 In third-world countries, infections are still reported as a common indication. 19 , 20 With better airway management and improving critical care, more number of tracheostomies were performed for prolonged ventilation, cardiopulmonary diseases, and neurological impairment. 21 – 25 Interestingly, we found that UAO obstruction was the most common indication from 2000 to 2009 and CNI was the most frequent indication for tracheostomy from 2010 to 2018.…”

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confidence: 99%

Tracheostomy in Pediatric Intensive Care Unit—A Two Decades of Experience

Sachdev

Chaudhari

Singh

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Aim and objective To study the profile, indications, related complications, and predictors of decannulation and mortality in patients who underwent tracheostomy in the pediatric intensive care unit (PICU). Materials and methods Retrospective analysis of prospectively collected data of tracheostomies was done on patients admitted at PICU. Demographics, primary diagnosis, indication of tracheostomy, and durations of endotracheal intubation, mechanical ventilation, and tracheostomy cannulation were recorded. The indication was recorded in one of the four categories—upper airway obstruction (UAO), central neurological impairment (CNI), prolonged mechanical ventilation, and peripheral neuromuscular disorders). Results Two hundred ninety cases were analyzed. UAO (42%) and CNI (48.2%) were main indications in the halves of the study period, respectively. Decannulation was successful in 188 (64.8%) patients. Seventy-seven percentage UAO patients were decannulated successfully [OR (odds ratio); 95% CI (confidence interval), 2.647; 1.182–5.924, p = 0.018]. Age <1 year (0.378; 0.187–0.764; p = 0.007), nontraumatic, noninfectious central neurological diseases (0.398; 0.186–0.855; p = 0.018), and malignancy (0.078; 0.021–0.298; p <0.001), durations of posttracheostomy ventilation (0.937; 0.893–0.983; p = 0.008), and stay in the PICU (0.989; 0.979–0.999; p = 0.029) were predictors of unsuccessful decannulation. There were 91 (31.4%) deaths. Age <1 year (2.39 (1.13–5.05; p = 0.02), malignancy (17.55; 4.10–75.11; p <0.001), durations of posttracheostomy ventilation (1.06; 1.006–1.10; p = 0.028), and hospital stay (1.007; 1.0–1.013; p = 0.043) were independent predictors of mortality. Indication of UAO favored survivor (0.24; 0.09–0.57; p <0.001). Conclusion The indications for tracheostomy in children had changed over the years. Infancy, primary diagnosis, length of posttracheostomy ventilation, and stay in the PICU and hospital were independent predictors of decannulation and mortality. What This Adds Similar to developed countries, the age at the time of tracheostomy and indication are changing. Inability to decannulate and mortality were associated with the age of a child at the time of tracheostomy, indication, medical diagnosis, and duration of postprocedure mechanical ventilation and stay in the hospital. How to cite this article Sachdev A, Chaudhari ND, Singh BP, Sharma N, Gupta D, Gupta N, et al . Tracheostomy in Pediatric Intensive Care Unit—A Two Decades of Experience. Indian J Crit Care Med 2021;25(7):803–81...

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