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Current trends in paediatric tracheostomies

Claudio Parrilla1, Emanuele Scarano, Maria Lavinia Guidi

  • 1Institute of Otolaryngology, Sacro Cuore Catholic University, Rome, Italy. claudioparrilla@yahoo.com

International Journal of Pediatric Otorhinolaryngology
|July 14, 2007
PubMed

Insights

Pediatric tracheostomy indications have shifted from airway obstruction to complications from long-term intubation, leading to younger patients and altered complication rates. This impacts tracheostomy management in children.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Critical Care Medicine

Background:

  • Historically, acute inflammatory airway obstruction was the primary reason for pediatric tracheostomy.
  • Advances in neonatal intensive care have introduced long-term intubation as an alternative, shifting tracheostomy indications.
  • Subglottic stenosis resulting from prolonged intubation is now a leading cause for tracheostomy in children.

Purpose of the Study:

  • To analyze the changing indications for tracheostomy in pediatric patients.
  • To evaluate the complication rates associated with tracheostomy in children.
  • To assess the impact of altered indications on patient demographics and outcomes.

Main Methods:

  • Retrospective analysis of 38 pediatric patients undergoing tracheostomy.
  • Data collected from a tertiary referral center between November 1998 and November 2004.
  • Patients treated for respiratory failure and upper airway obstruction.

Main Results:

  • Overall complication rate was 42.1%.
  • Complication rates were higher in younger children (under 1 year: 47.4%) compared to older children (over 1 year: 26.3%).
  • Decannulation was attempted in 12 patients after an average cannulation time of 22 months.

Conclusions:

  • Long-term intubation sequelae are a major indication for pediatric tracheostomy.
  • The shift in indications has led to a younger average age of children requiring tracheostomy.
  • Longer cannulation times and younger patient age influence tracheostomy complication rates in pediatric populations.
Abstract

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