OBJECTIVE: To examine complications of pediatric tracheostomy. STUDY DESIGN: Retrospective. METHODS: Chart review of children undergoing tracheotomy or laryngeal diversion between 1990 and 1999. RESULTS: Charts of 142 children were examined. Average age was 2.64 years (standard deviation [SD], 4.73 y) at surgery. Duration of tracheostomy was 2.08 years (SD, 1.72 y) for those decannulated, 3.12 years (SD, 2.5 y) for those still with a stoma, and length of follow-up for the whole group was 4.14 years (SD, 8.69 y). At last follow-up, 56% had a tracheostomy, 29% had none, and 15% had died; one death was tracheostomy-related. Three percent had intraoperative complications, 11% had complications before the first tracheostomy tube change, and 63% had complications after the first tube change. Thirty-four percent had a trial of decannulation; 85% of these were successful. Fifty-four percent of those decannulated had complications. Number of complications was not related to duration of follow-up. In-hospital mortality was congruent to mortality predicted by PRISM (Pediatric Rate of Mortality) scores. CONCLUSIONS: Forty-three percent had serious complications involving loss of the tracheostomy airway (tube occlusion or accidental decannulation) or requiring a separate surgical procedure. Deaths directly attributable to tracheostomy complications occurred in 0.7%.
OBJECTIVE: To examine complications of pediatric tracheostomy. STUDY DESIGN: Retrospective. METHODS: Chart review of children undergoing tracheotomy or laryngeal diversion between 1990 and 1999. RESULTS: Charts of 142 children were examined. Average age was 2.64 years (standard deviation [SD], 4.73 y) at surgery. Duration of tracheostomy was 2.08 years (SD, 1.72 y) for those decannulated, 3.12 years (SD, 2.5 y) for those still with a stoma, and length of follow-up for the whole group was 4.14 years (SD, 8.69 y). At last follow-up, 56% had a tracheostomy, 29% had none, and 15% had died; one death was tracheostomy-related. Three percent had intraoperative complications, 11% had complications before the first tracheostomy tube change, and 63% had complications after the first tube change. Thirty-four percent had a trial of decannulation; 85% of these were successful. Fifty-four percent of those decannulated had complications. Number of complications was not related to duration of follow-up. In-hospital mortality was congruent to mortality predicted by PRISM (Pediatric Rate of Mortality) scores. CONCLUSIONS: Forty-three percent had serious complications involving loss of the tracheostomy airway (tube occlusion or accidental decannulation) or requiring a separate surgical procedure. Deaths directly attributable to tracheostomy complications occurred in 0.7%.
Authors: Robert J Morrison; Scott J Hollister; Matthew F Niedner; Maryam Ghadimi Mahani; Albert H Park; Deepak K Mehta; Richard G Ohye; Glenn E Green Journal: Sci Transl Med Date: 2015-04-29 Impact factor: 17.956
Authors: Tessie W October; Amy H Jones; Hannah Greenlick Michals; Lauren M Hebert; Jiji Jiang; Jichuan Wang Journal: Pediatr Crit Care Med Date: 2020-02 Impact factor: 3.624