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The changing indications for paediatric tracheostomy.

Pandora J Hadfield1, Ruth V Lloyd-Faulconbridge, John Almeyda

  • 1Department of Paediatric Otolaryngology, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.

International Journal of Pediatric Otorhinolaryngology
|February 1, 2003
PubMed
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Paediatric tracheostomy rates increased slightly, driven by conditions like airway stenosis and prolonged ventilation needs. While some indications decreased, overall use rose, highlighting evolving pediatric respiratory care challenges.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Surgical Outcomes

Background:

  • Paediatric tracheostomy is a critical intervention for managing complex airway issues in children.
  • Understanding trends in its indications and incidence is vital for resource allocation and clinical practice.
  • Previous studies have indicated shifts in the reasons for performing tracheostomies in pediatric populations.

Purpose of the Study:

  • To analyze changes in the incidence and primary indications for paediatric tracheostomy over a defined period.
  • To identify specific conditions contributing to any observed increase or decrease in tracheostomy procedures.
  • To provide updated data on paediatric airway management strategies.

Main Methods:

  • Retrospective review of a departmental database.

Related Experiment Videos

  • Inclusion of all paediatric tracheostomies performed between 1993 and 2001.
  • Case note review to determine specific indications for each procedure.

    • Main Results:

    • A total of 362 paediatric tracheostomies were performed during the 9-year study period.
    • A slight increase in the number of procedures was observed between the first and second halves of the study, with peaks in 1997 and 1999.
    • The most frequent indication for tracheostomy was prolonged mechanical ventilation due to neuromuscular or respiratory insufficiency.

    Conclusions:

    • The rising frequency of paediatric tracheostomy is attributed to conditions including subglottic/tracheal stenosis, respiratory papillomatosis, caustic alkali ingestion, and craniofacial syndromes.
    • Tracheostomies for subglottic haemangioma and laryngeal clefts have become less common.
    • Despite shifts in specific indications, prolonged ventilation remains the predominant reason for paediatric tracheostomy.