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Changing Indications for Pediatric Tracheotomy: An Urban Indian Study
Saudamini J Lele1, Sharafine Stephen1, Eswaran V Raman1
1Department of Otolaryngology and Head Neck Surgery, Children's Airway and Swallowing Centre, Manipal Hospitals, 98, HAL Airport Road, Bangalore, India.
Summary
Pediatric tracheotomy indications have shifted, with neurological impairment now more common than airway obstruction. While complications are rare, successful decannulation rates are significant, and tracheotomy itself is not directly linked to mortality.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Critical Care Medicine
Background:
- Pediatric tracheotomy practices have evolved due to advances in healthcare.
- Understanding current trends in indications, outcomes, and complications is crucial.
Purpose of the Study:
- To review changing indications for pediatric tracheotomy.
- To analyze decannulation rates, complications, and mortality associated with pediatric tracheotomies.
Main Methods:
- Retrospective analysis of medical records for children undergoing tracheotomy between April 2003 and December 2015.
- Data collected included patient demographics, diagnoses, and tracheotomy indications.
- Outcomes assessed were complications, mortality, and decannulation rates.
Main Results:
- Neurological impairment has become the leading indication for pediatric tracheotomy, surpassing obstructive airway issues.
- Of 99 patients, 58 were successfully decannulated.
- 13 patients died during treatment, with no direct attribution to the tracheotomy procedure itself.
- Complications included peristomal granulations, stomal infection, and tracheocutaneous fistula.
Conclusions:
- Pediatric tracheotomy indications have shifted towards neurological impairment.
- The procedure demonstrates a favorable safety profile with manageable complications.
- Successful decannulation is achievable in a significant proportion of pediatric patients.
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