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Published on: January 17, 2011
Pediatric tracheostomy: a 13-year experience
1Department of Pediatric Surgery, St. John's Medical College Hospital, 560034 Bangalore, India.
Insights
Pediatric tracheostomy is a safe procedure for airway management in infants and neonates. Home care by parents is feasible, with most patients experiencing minor complications and successful decannulation.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Critical Care Medicine
Background:
- Pediatric tracheostomy is associated with significant morbidity and mortality.
- Indications and outcomes for pediatric tracheostomy have evolved over time.
- Recent trends in pediatric airway management require updated data.
Purpose of the Study:
- To review institutional experience with pediatric tracheostomy over 13 years.
- To analyze trends in indications, complications, and outcomes.
- To assess the feasibility and safety of home tracheostomy care by parents.
Main Methods:
- Retrospective analysis of hospital records for pediatric tracheostomy patients.
- Data collected included age, gender, indication, duration, complications, and follow-up.
- Thirty-nine tracheotomies in 36 patients were reviewed.
Main Results:
- Males outnumbered females 2:1; mean age was 41.6 months, with nearly a third being newborns.
- Indications included congenital and acquired obstructive lesions.
- Most patients (30/39) were successfully decannulated, with minor, transient post-decannulation complications. One tracheostomy-related death occurred.
Conclusions:
- Pediatric tracheostomy is a safe procedure, especially in neonates and infants.
- Home tracheostomy care managed by parents is feasible and effective.
- Outcomes have improved, with reduced major complications compared to literature.
Abstract:
Pediatric tracheostomy has been reported to be a surgical procedure with significant morbidity and mortality. The use of tracheostomy in airway management has changed over time as regards indication and outcome. A review of the last 13 years' experience in our institution was carried out to focus on this group of patients and the recent trends in airway management. A retrospective analysis of hospital records was done and information collected with respect to age, gender, indication for tracheostomy, duration, complications, and follow-up. Thirty-nine tracheotomies were done in 36 patients, of whom males outnumbered females 2:1. The mean patient age was 41.6 months while nearly a third were newborns. The indications were congenital and acquired obstructive lesions. Apart from nine cases, all have been treated and decannulated. Follow-up ranged from 1 month to 8 years, and decannulation time from 48 h to 45 months. Home tracheostomy care was very well managed by the parents. One tracheostomy-related death was encountered. Complications were minor and transient and occurred post-decannulation in our series, in contrast to the major complications, both acute and chronic, reported in the literature. More neonates and infants are undergoing tracheostomy and surviving. Pediatric tracheostomy is a safe procedure with home care by parents feasible.
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