Tracheostomy Following Surgery for Congenital Heart Disease

Benneyworth, Brian D.; Shao, Jenny M.; Cristea, A. Ioana; Ackerman, Veda L.; Rodefeld, Mark D.; Turrentine, Mark W.; Brown, John W.

doi:10.1177/2150135116644432

Cited by 13 publications

(21 citation statements)

References 25 publications

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“…In children requiring surgery for congenital heart disease and a tracheostomy, hospital discharge rates are as low as 50%, in those patients with pulmonary artery shunts, hypoplastic left heart syndrome, and coexisting genetic syndromes. 46 , 47 , 48 , 49 …”

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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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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“…The frequency of tracheostomy in children with cardiac disease has, however, increased in recent years (2,4,5). Indications for tracheostomy for children with cardiac disease are often multifactorial, and long-term survival is as low as 50% (15)(16)(17)(18)(19)(20)(21)(22). Although studies describe the epidemiology of pediatric patients with cardiac disease undergoing tracheostomy, most are restricted to single-center studies with small cohorts, limited outcomes, specific cardiac diagnoses, or a few multicenter studies that lack longitudinal follow-up data (3)(4)(5)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: E557mentioning

confidence: 99%

Tracheostomy Timing During Pediatric Cardiac Intensive Care: Single Referral Center Retrospective Cohort

Fox,

Meyer-Macaulay,

Roberts

et al. 2023

Pediatric Critical Care Medicine

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OBJECTIVES: To describe associations between the timing of tracheostomy and patient characteristics or outcomes in the cardiac ICU (CICU). DESIGN: Single-institution retrospective cohort study. SETTING: Freestanding academic children’s hospital. PATIENTS: CICU patients with tracheostomy placed between July 1, 2011, and July 1, 2020. INTERVENTIONS: We compared patient characteristics and outcomes between early and late tracheostomy based on the duration of positive pressure ventilation (PPV) before tracheostomy placement, fitting a receiver operating characteristic curve for current survival to define a cutoff. MEASUREMENTS AND MAIN RESULTS: Sixty-one patients underwent tracheostomy placement (0.5% of CICU admissions). Median age was 7.8 months. Eighteen patients (30%) had single ventricle physiology and 13 patients (21%) had pulmonary vein stenosis (PVS). Primary indications for tracheostomy were pulmonary/lower airway (41%), upper airway obstruction (UAO) (31%), cardiac (15%), neuromuscular (4%), or neurologic (4%). In-hospital mortality was 26% with 41% survival at the current follow-up (median 7.8 [interquartile range, IQR 2.6–30.0] mo). Late tracheostomy was defined as greater than or equal to 7 weeks of PPV which was equivalent to the median PPV duration pre-tracheostomy. Patients with late tracheostomy were more likely to be younger, have single ventricle physiology, and have greater respiratory severity. Patients with early tracheostomy were more likely to have UAO or genetic comorbidities. In multivariable analysis, late tracheostomy was associated with 4.2 times greater mortality (95% CI, 1.9–9.0). PVS was associated with higher mortality (adjusted hazard ratio [HR] 5.2; 95% CI, 2.5–10.9). UAO was associated with lower mortality (adjusted HR 0.2; 95% CI, 0.1–0.5). Late tracheostomy was also associated with greater cumulative opioid exposure. CONCLUSIONS: CICU patients who underwent tracheostomy had high in-hospital and longer-term mortality rates. Tracheostomy timing decisions are influenced by indication, disease, genetic comorbidities, illness severity, and age. Earlier tracheostomy was associated with lower sedative use and improved adjusted survival. Tracheostomy placement is a complex decision demanding individualized consideration of risk-benefit profiles and thoughtful family counseling.

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“…17 Sadece konjenital kalp cerrahisi sonrası trakeotomi açılan hastaların incelendiği çalışmalarda konjenital kalp hastalığı nedeni ile opere edilen hastalarda trakeotomi açılmasının kötü prognozla ilişkili olduğu ve ortalama %0,2-2,7 hastada trakeotomi ihtiyacı doğduğu bildirilmektedir. 18,19 Saygı ve ark., pediatrik kardiyak cerrahi uygulanan 1.450 hastada trakeotomi gereken hasta sayısını 18 olarak bildirmişlerdir. 20 Hastaların ortalama ağırlığı 5,8±2,9 kg, trakeotomi öncesi ortalama entübasyon süreleri ise 41±12,9 gün olarak bildirilmiştir.…”

Section: Gereç Ve Yöntemlerunclassified

Pediatric Tracheotomy: A Single Center Pediatric Cardiac Intensive Care Unit Experience

Akdoğan¹,

Gökdemir²,

Cındık³

et al. 2019

KBB ve BBC Dergisi

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Bu çalışmada, hastanemizde gerçekleştirilmiş olan pediatrik trakeotomilerin retrospektif analizi sağlanarak elde edilen bulguların literatürle karşılaştırılması ve olası benzer ve farklı yönlerin ortaya konması hedeflenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Başkent Üniversitesi Konya Eğitim ve Araştırma Merkezi'nde Ocak 2015-Mayıs 2019 tarihleri arasında gerçekleştirilmiş olan pediatrik trakeotomiler retrospektif olarak incelenmiştir. Hastane bilgi sisteminden, trakeotomi açılan 16 yaş altı tüm hastalar tespit edilmiş; hastaların trakeotomi açılma endikasyonları, entübasyon süreleri, trakeotominin açıldığı dönemdeki yaş ve kiloları, karşılaşılan komplikasyonlar, mortalite ve dekanülasyon durumları incelenmiştir. B Bu ul lg gu ul la ar r: : Toplam 35 hastaya trakeotomi açıldığı tespit edildi. Tüm hastalara standart trakeotomi prosedürü uygulandı. Hastaların 15 (%42,9)'i erkek, 20 (%57,1)'si ise kız idi. Hastaların %60 (n=21)'ında geçirilmiş kardiyak cerrahi söz konusuydu. Ortalama yaş 13 ay (1-90 ay) idi. Hastaların %77 (n=27)'si bir yaş altındaydı. Bu oran, kardiyak cerrahi geçiren grupta %80,9 idi. İşlem sırasında hastaların ortalama kiloları 6,192 gram idi. En sık trakeotomi endikasyonu nörolojik nedenlere bağlı olup (14 hasta; %40), bunu sırasıyla uzamış entübasyon (11 hasta; %31,4) ve üst hava yolu obstrüksiyonu (10 hasta; %28,6) takip etmekteydi. İki (%5,7) hastada majör komplikasyon izlenirken, trakeotomiye bağlı mortalite 1 (%2,8) hastada ortaya çıktı. S So on nu uç ç: : Pediatrik trakeotomi işlemi, özellikle son yıllarda pediatrik yoğun bakım hizmetlerindeki gelişmelerle daha sık ihtiyaç duyulan özellikli bir cerrahidir. Bu çalışmada, hastalarımızda en sık trakeotomi endikasyonunun nörolojik nedenlere bağlı olduğu, kardiyak cerrahi geçiren hastalarda ise uzamış entübasyon ve üst havayolu tıkanıklığının etiyolojide yer aldığı tespit edilmiştir. Majör komplikasyon ve mortalite oranlarımız kabul edilebilir sınırlarda iken dekanülasyon oranlarımızın düşük olduğu görülmüştür.

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Tracheostomy Following Surgery for Congenital Heart Disease

Abstract: (Word Count 243/250):Background: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and

Cited by 13 publications

References 25 publications

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

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

Tracheostomy Timing During Pediatric Cardiac Intensive Care: Single Referral Center Retrospective Cohort

Pediatric Tracheotomy: A Single Center Pediatric Cardiac Intensive Care Unit Experience

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