The Evaluation of Tracheotomy Cases in the Pediatric Intensive Care Unit: The Results of Decanulation and Weaning from Mechanical Ventilator

Abstract

ÖzETAmaç: Hastaların sedasyon ihtiyacını azaltması, pulmoner sekresyonların temizliğinin daha etkin yapılabilmesi, yoğun-bakım yatış gün sayısı üzerine olan olumlu katkılarından dolayı trakeotomi çocuk yoğunbakım uzmanlarının sıkça başvur-duğu bir cerrahi prosedür haline gelmiştir. Daha önce trakeotomi endikasyonları, zamanlaması ve komplikasyonları gibi konularla ilgili bir çok çalışma yapılmış olmasına rağmen mekanik ventilatörden ayrılma ve dekanülasyon ile ilgili bilgiler sınırlıdır. Bu çalışmada trakeotomi sonrası mekanik ventilatörden ayrılma ve dekanülasyon sonuçlarınının değerlendiril-mesi amaçlanmıştır. ABSTRAcTObjective: Tracheostomy has become a frequent surgical procedure for pediatric intensivists asit reduces the patient's sedation needs and the length of the Pediatric Intensive Care Unit (PICU) stay and also improves the efficiency of pulmonary secretion clearance. Despite previous studies on tracheostomy indications, timing and complications, there is limited information on extubation success and decanulation. In this study, we aimed to present the decanulation and weaning from mechanical ventilator results after tracheostomy. Material and Methods: This study was carried out retrospectively from the records of patients who underwent tracheostomy between January 2010 and August 2016 at the Erciyes University Medical Faculty Pediatric Intensive Care Unit. Results: A total of 107 patients were included in this study. There were 55 (51.4%) males and 52 (48.6%) females. The median age of the patients was 23 (10-79) months and the duration of mechanical ventilation before tracheostomy was 23 (17-30) days. The most common indication was long-term ventilation (81.3%), followed by airway abstruction (14%), and pulmonary toilet (4.7%). Sixty five were weaned from the mechanical ventilator and 28% of the patients were decannulated. The ET group PICU stay was 23 (15-32) days, and the LT group PICU stay was 52 (40-79) days (p<0.01). There was no significant difference in mortality between the two groups (p=0.786). conclusion: Tracheostomy is a good choice in terms of alleviating the chronic patient burden in our country where there is limited pediatric intensive care capacity