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Related Experiment Videos

Pediatric tracheostomy: a changing procedure?

R F Wetmore1, R R Marsh, M E Thompson

  • 1Department of Pediatric Otolaryngology, The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, 19104, USA.

The Annals of Otology, Rhinology, and Laryngology
|August 6, 1999
PubMed
Summary
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This study reviews 450 tracheostomy cases from 1981-1992, finding an increase in long-term use and a decrease in tracheostomy-related mortality due to improved monitoring and parental education.

Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Respiratory Medicine

Background:

  • The Children's Hospital of Philadelphia previously reported tracheostomy experience from 1971-1980.
  • A review of 450 tracheostomy cases from 1981-1992 was conducted to update institutional data.
  • Long-term follow-up (median 2.96 years) was achieved for 83% of patients.

Purpose of the Study:

  • To analyze trends in tracheostomy indications and outcomes over a decade (1981-1992).
  • To compare current tracheostomy practices and complications with a previous institutional report (1971-1980).
  • To evaluate tracheostomy-related mortality and morbidity in pediatric patients.

Main Methods:

  • Retrospective review of 450 pediatric tracheostomy cases from 1981 to 1992.

Related Experiment Videos

  • Comparison of patient characteristics and outcomes with a prior study (1971-1980).
  • Analysis of indications for tracheostomy, duration, complications, and mortality.

    • Main Results:

    • Tracheostomy was performed for airway obstruction (38%), chronic ventilation (53%), and multiple indications (9%).
    • Mean tracheotomy duration was 2.13 years; tracheostomy-related mortality was 0.5%, while non-tracheostomy-related mortality was 22%.
    • Nineteen percent experienced early complications, and 58% had late complications. There was increased long-term tracheostomy use and decreased short-term use compared to the prior study.

    Conclusions:

    • A significant increase in long-term tracheostomy use was observed.
    • There is a continuing trend away from tracheostomy for short-term airway management.
    • Improved monitoring and parental education likely contributed to reduced tracheostomy-related mortality.