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Tracheotomy in the first year of life: outcomes in term infants, the Vanderbilt experience

Christopher T Wootten1, Lesley C French, Robert G Thomas

  • 1Department of Otolaryngology, Vanderbilt University, 7209 Medical Center East, 1215 21st Avenue South, Nashville, TN 37232-8605, USA. christopher.t.wootten@vanderbilt.edu

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 28, 2006
PubMed

Insights

Tracheotomies in term infants show favorable decannulation rates compared to preterm infants, though non-tracheotomy-related mortality remains high. Upper airway obstruction is a common indication in term infants.

Area of Science:

  • Pediatric critical care
  • Neonatology
  • Otolaryngology

Background:

  • Critical care for preterm infants is advancing.
  • Tracheotomies are performed in infants for various reasons.
  • Understanding outcomes in term versus preterm infants is crucial.

Purpose of the Study:

  • To compare indications and outcomes of tracheotomies in term versus preterm infants within the first year of life.
  • To analyze factors influencing tracheotomy success and mortality in these groups.

Main Methods:

  • Retrospective study of 127 tracheotomies in infants (term and preterm) from 1988-2004.
  • Data collected on gestational age, indications, subsequent procedures, decannulation rates, and mortality.

Main Results:

  • Term infants had a mean gestational age of 38.97 weeks; preterm infants averaged 29.71 weeks.
  • Upper airway abnormalities were the primary indication (53%) in term infants.
  • Term infants required fewer subsequent procedures, had a 36.3% decannulation rate, and a 20.5% mortality rate.

Conclusions:

  • Term infants demonstrated a better decannulation rate than preterm infants, with less chronic lung disease.
  • High mortality rates in term infants were often linked to comorbidities unrelated to the tracheotomy itself.
  • Tracheotomies for upper airway obstruction in term infants are associated with adverse outcomes due to coexisting conditions.
Abstract

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