Tracheostomy: Acute and long-term mortality and morbidity in very low birth weight premature infants

Schlessel, Jerrold S.; Harper, Rita G.; Rappa, Heidi A.; Kenigsberg, Kenneth; Khanna, Suresh

doi:10.1016/0022-3468(93)90685-e

Cited by 30 publications

(34 citation statements)

References 13 publications

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“…3,11 This is likely because we included all infants admitted to the NICU, and previous studies focused on low birth weight infants (<2500 g) or those with BPD. 5,6,11,12 In a single-center study including all infants regardless of diagnosis or GA, tracheostomy rate was still higher than our cohort at 1.8%. 3 The Pediatrix Clinical Data Warehouse, the data source for our study, represents a broad mix of NICUs of different acuity levels including academic medical centers and community hospitals, and may be a more accurate representation of the NICU population across the United States.…”

Section: Discussioncontrasting

confidence: 64%

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Risk Factors and In-Hospital Outcomes following Tracheostomy in Infants

Lee

Smith

Quek

et al. 2016

The Journal of Pediatrics

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Objective To describe the epidemiology, risk factors, and in-hospital outcomes of tracheostomy in infants in the neonatal intensive care unit (NICU). Study design We analyzed an electronic medical record from 348 NICUs from 1997–2012, and evaluated the associations between infant demographics, diagnoses, and pre-tracheostomy cardio-pulmonary support with in-hospital mortality. We also determined the trends in use of infant tracheostomy over time. Results We identified 885/887,910 (0.1%) infants who received a tracheostomy at a median postnatal and postmenstrual age of 72 days (25th, 75th percentile 27, 119) and 42 weeks (39, 46) respectively. The most common diagnoses associated with tracheostomy were bronchopulmonary dysplasia [396/885 (45%)], other upper airway anomalies [202/885 (23%)], and laryngeal anomalies [115/885 (13%)]. In-hospital mortality after tracheostomy was 125/885 (14%). On adjusted analysis, gestational age (GA) near term, small for gestational age (SGA) status, pulmonary diagnoses, number of days of FiO2>0.4, and inotropic support before tracheostomy were associated with increased in-hospital mortality. The proportion of infants requiring tracheostomy increased from 0.01% in 1997 to 0.1% in 2005 (P<0.001), but has remained stable since. Conclusions Tracheostomy is uncommonly performed in hospitalized infants, but the associated mortality is high. Risk factors for increased in-hospital mortality after tracheostomy include GA near term, SGA, and pulmonary diagnoses.

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Section: Discussioncontrasting

confidence: 64%

“…This finding is again consistent with previous studies, which have reported overall mortality rates ranging from 16% to 25%. 3,8,12,14 …”

Section: Discussionmentioning

confidence: 99%

Risk Factors and In-Hospital Outcomes following Tracheostomy in Infants

Lee

Smith

Quek

et al. 2016

The Journal of Pediatrics

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“…Data from several studies of pediatric tracheostomies suggest a decrease in age and an increase in duration 6−12 . Similar to other reports in this series we observed an increase in number of cases with tracheostomy and a decrease of age in recent years.…”

Section: Discussionsupporting

confidence: 90%

Tracheostomy in childhood: 20 years experience from a pediatric surgery clinic

İlçe

Celayır

Tekand

et al. 2002

Pediatrics International

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Tracheostomy is a life saving procedure when performed with an appropriate indication and surgical technique. Therefore, the pediatric surgeons dealing with this procedure should be aware of the tracheostomy care problems, fatal complications and the need for reconstructive surgery. With strict indications and experience of the procedure, this should be enough effort to minimize its complications and related care problems.

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“…Therefore, even a slight reduction of the endotracheal diameter can potentially obstruct the airway. In addition, some authors observed that almost half of the patients under 1 year of age suffer from a bronchopulmonary dysplasia, which prompts the development of viscous and abundant bronchial secretion, thus increasing the risk of significant early and long-term tracheal complications [12,20].…”

Section: Discussionmentioning

confidence: 99%