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Tracheotomy in children: evolution in indications

C S Butnaru1, M P Colreavy, S Ayari

  • 1Otolaryngology Department, Edouard Herriot Universitary Hospital, Place d'Arsonval, 69437 Lyon Cedex 03, France.

International Journal of Pediatric Otorhinolaryngology
|September 20, 2005
PubMed

Insights

Pediatric tracheostomy indications are shifting towards prolonged ventilator dependence, with upper airway obstructions decreasing. This trend highlights advancements in medical technology and care for children with chronic respiratory conditions.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Respiratory Medicine
  • Pediatric Surgery

Background:

  • Tracheostomy is a critical intervention for pediatric airway management.
  • Understanding trends in tracheostomy indications is essential for optimizing patient care and resource allocation.

Purpose of the Study:

  • To analyze the changing reasons for performing tracheostomies in children.
  • To identify shifts in indications over time and correlate them with medical advancements.

Main Methods:

  • Retrospective chart review of 46 pediatric patients who underwent tracheostomy.
  • Data collected between 1996 and 2001.
  • Indications categorized into prolonged ventilator dependence and upper airway obstructions.

Main Results:

  • Prolonged ventilator dependence accounted for 57% of tracheostomies, while upper airway obstructions represented 43%.
  • The frequency of tracheostomies for upper airway obstructions decreased.
  • An increasing trend was observed for chronic disorders necessitating prolonged mechanical ventilation.
  • Decannulation was successful in 52% of cases, with a 2.7% mortality rate directly related to the procedure.

Conclusions:

  • Ventilator dependence has emerged as the primary evolving indication for pediatric tracheostomy.
  • The use of tracheostomy for upper airway obstruction has declined, partly due to progress in endoscopic airway management techniques.
Abstract

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