Tracheostomy in Preterm Infants

Pereira, Kevin D.; MacGregor, Allison R.; McDuffie, Chad M.; Mitchell, Ron B.

doi:10.1001/archotol.129.12.1268

Cited by 73 publications

(70 citation statements)

References 33 publications

(43 reference statements)

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“…Lagatta et al [18] reported that 28% of extremely preterm infants (< 28 weeks’ GA) were discharged from the NICU on home oxygen. Similar to other studies, the complexity of care of preterm children with home assistive technology was reflected by the frequent encounters with the health care system including re-admissions and outpatient clinic attendances, above and beyond what was observed for other preterm children [17, 19]. Therefore, the caregiving burden on families is substantial and needs to be considered over the continuum of care.…”

Section: Discussion/conclusionsupporting

confidence: 54%

Very Preterm Infants with Technological Dependence at Home: Impact on Resource Use and Family

Nassel¹,

Chartrand

Doré-Bergeron

et al. 2019

Neonatology

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Objective: To examine the impact of medical complexity among very preterm infants on health care resource use, family, and neurodevelopmental outcomes at 18 months’ corrected age. Methods: This observational cohort study of Canadian infants born < 29 weeks’ gestational age in 2009–2011 compared infants with and those without medical complexity defined as discharged home with assistive medical technology. Health care resource use and family outcomes were collected. Children were assessed for cerebral palsy, deafness, blindness, and developmental delay at 18 months. Logistic regression analysis was performed for group comparisons. Results: Overall, 466/2,337 infants (20%) needed assistive medical technology at home including oxygen (79%), gavage feeding (21%), gastrostomy or ileostomy (20%), CPAP (5%), and tracheostomy (3%). Children with medical complexity were more likely to be re-hospitalized (OR 3.6, 95% CI 3.0–4.5) and to require ≥2 outpatient services (OR 4.4, 95% CI 3.5–5.6). Employment of both parents at 18 months was also less frequent in those with medical complexity compared to those without medical complexity (52 vs. 60%, p < 0.01). Thirty percent of children with medical complexity had significant neurodevelopmental impairment compared to 13% of those without medical complexity (p < 0.01). Lower gestational age, lower birth weight, bronchopulmonary dysplasia, sepsis, and surgical necrotizing enterocolitis were associated with a risk of medical complexity. Conclusion: Medical complexity is common following very preterm birth and has a significant impact on health care use as well as family employment and is more often associated with neurodevelopmental disabilities. Efforts should be deployed to facilitate care coordination upon hospital discharge and to support families of preterm children with medical complexity.

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Section: Discussion/conclusionsupporting

confidence: 54%

Very Preterm Infants with Technological Dependence at Home: Impact on Resource Use and Family

Nassel¹,

Chartrand

Doré-Bergeron

et al. 2019

Neonatology

View full text Add to dashboard Cite

show abstract

“…From a large literature review, Kremer et al [43] concluded that most fatalities of patients with tracheotomy result from their underlying medical condition and not the tracheotomy itself. In fact, several authors have reported relatively low morbidity and mortality with pediatric tracheotomy, even in neonates [46][47][48]. There was no mortality in our patients managed with tracheotomy.…”

Section: Discussionmentioning

confidence: 47%

Robin sequence: A retrospective review of 115 patients

Evans

Rahbar

Rogers

et al. 2006

International Journal of Pediatric Otorhinolaryngology

226

204

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“…These comorbidities can contribute to the need for prolonged ventilatory dependence in this population. Pereira et al demonstrated that of all comorbidities, the severity of pulmonary disease was the best predictor of the need for tracheostomy in preterm infants [3]. The literature is replete with reviews of the complications of prolonged ventilatory support in preterm infants.…”

Section: Introductionmentioning

confidence: 99%