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Tracheostomy in pediatric patients
1Department of Otolaryngology, University Central Hospital, Turku, Finland.
Insights
Pediatric tracheostomy is most common in children under two years old, primarily for subglottic stenosis or respiratory distress. Strict indications are crucial due to a 30% complication rate.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Critical Care Medicine
Background:
- Tracheostomy is a surgical procedure to create an airway.
- Pediatric tracheostomy indications and outcomes require careful evaluation.
Purpose of the Study:
- To analyze the indications, outcomes, and complications of pediatric tracheostomy.
- To emphasize the importance of strict criteria for performing pediatric tracheostomies.
Main Methods:
- Retrospective review of 33 pediatric tracheostomies performed between 1978 and 1987.
- Analysis of patient demographics, indications, duration of intubation and tracheostomy, and complications.
Main Results:
- 33 children (13 male, 20 female) underwent tracheostomy, with a mean age of 726 days (76% < 2 years).
- Common indications included subglottic stenosis (13) and respiratory distress syndrome with prolonged endotracheal ventilation (11).
- Mean endotracheal intubation duration was 64 days, and tracheostomy treatment was 117 days, with a 30% complication rate and one tracheostomy-related death.
Conclusions:
- Pediatric tracheostomy is frequently performed in infants and young children.
- Subglottic stenosis and prolonged ventilation are primary indications.
- Strict adherence to indications is vital to minimize complications and mortality in pediatric tracheostomy cases.
Abstract:
From 1978 to 1987, tracheostomy was performed on 33 children, 13 boys and 20 girls, with a male to female ratio of 0.65:1. The mean age at the time of tracheostomy was 726 days, 76% of the children being under the age of two years. The incidence of pediatric tracheostomy per hospital admissions was 0.05%. Subglottic stenosis (13 children) and respiratory distress syndrome with prolonged endotracheal ventilation (11 children) were the most common indications for tracheostomy. The mean duration of prolonged endotracheal intubation before tracheostomy was 64 days, and that of tracheostomy treatment 117 days. During the tracheostomy period, five children died, but only one death was related to tracheostomy. The total rate of complications was 30%. We emphasize the importance of strict indications for pediatric tracheostomy.