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Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Pediatric tracheotomies: changing indications and outcomes
J D Carron1, C S Derkay, G L Strope
1Department of Otolaryngology--Head and Neck Surgery, Eastern Virginia Medical School and Children's Hospital of the King's Daughters, Norfolk 23507, USA.
The Laryngoscope
|July 13, 2000
Summary
Pediatric tracheotomy is common in children's hospitals. While mortality is high, it's usually due to underlying conditions, not the procedure itself, with changing indications over time.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Critical Care Medicine
Background:
- Pediatric tracheotomy is a significant surgical procedure for managing complex airway issues in children.
- Understanding trends in indications and outcomes is crucial for optimizing patient care.
Purpose of the Study:
- To analyze outcomes and complications of pediatric tracheotomy.
- To investigate shifts in indications and outcomes since 1970.
Main Methods:
- Retrospective chart review of 204 pediatric tracheotomies performed between 1988 and 1998.
- Categorization of indications: craniofacial abnormalities, airway obstruction, prolonged intubation, neurological impairment, trauma, and vocal fold paralysis.
Main Results:
- Average age at tracheotomy was 3.2 years; indications varied by age group.
- Decannulation achieved in 41% of patients; time to decannulation differed significantly by indication.
- Complications occurred in 44%, overall mortality was 19% (3.6% tracheotomy-related).
- Fewer procedures for infections, more for chronic diseases since 1970, with decreased decannulation rates.
Conclusions:
- Pediatric tracheotomy is frequently performed in tertiary care settings.
- High mortality rates are primarily linked to underlying comorbidities, not the tracheotomy procedure.
- Trends show a shift towards chronic disease indications and longer tracheotomy durations.
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