Related Experiment Video
Updated: Jul 27, 2025
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Outcomes of Gastrostomy and Tracheostomy in Infants Undergoing Truncus Arteriosus Repair: Database Study Using the
Jessica E Hook1, Dennis R Delany2, Jason R Buckley1
1Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina College of Medicine, Charleston, SC.
Insights
Tracheostomy in infants undergoing truncus arteriosus repair increases mortality risk. Both gastrostomy and tracheostomy significantly prolong postoperative length of stay, impacting infant outcomes.
Area of Science:
- Pediatric Surgery
- Congenital Heart Disease
- Critical Care Medicine
Background:
- Truncus arteriosus repair is a complex procedure in infants.
- Gastrostomy tubes and tracheostomies are interventions used to support infants with complex medical needs.
- Understanding the factors and outcomes associated with these interventions is crucial for optimizing care.
Purpose of the Study:
- To determine the prevalence of gastrostomy tube and tracheostomy placement in infants undergoing truncus arteriosus repair.
- To identify factors associated with these placements.
- To examine the association between these procedures and patient outcomes, including mortality and prolonged length of stay.
Main Methods:
- Retrospective cohort study utilizing the Pediatric Health Information System database.
- Analysis of infants under 90 days old who underwent truncus arteriosus repair between 2004 and 2019.
- Multivariable logistic regression models were employed to identify associated factors and outcomes.
Main Results:
- Gastrostomy tube placement occurred in 11.9% and tracheostomy in 3.4% of 1,645 infants.
- Factors associated with gastrostomy tube placement included DiGeorge syndrome, airway anomalies, and failure to thrive.
- Tracheostomy was associated with congenital airway anomaly and truncal valve surgery.
- Both gastrostomy and tracheostomy were independently associated with prolonged postoperative length of stay.
- Tracheostomy was independently associated with increased hospital mortality.
Conclusions:
- Tracheostomy placement in infants undergoing truncus arteriosus repair is linked to higher mortality rates.
- Both gastrostomy and tracheostomy are strongly associated with significantly prolonged postoperative length of stay.
- These findings highlight the importance of considering associated comorbidities and the impact of these interventions on infant recovery.
Objectives:
We sought to determine the prevalence of and factors associated with gastrostomy tube placement and tracheostomy in infants undergoing truncus arteriosus repair, and associations between these procedures and outcome.
Design:
Retrospective cohort study.
Setting:
Pediatric Health Information System database.
Patients:
Infants less than 90 days old who underwent truncus arteriosus repair from 2004 to 2019.
Interventions:
None.
Measurements And Main Results:
Multivariable logistic regression models were used to identify factors associated with gastrostomy tube and tracheostomy placement and to identify associations between these procedures and hospital mortality and prolonged postoperative length of stay (LOS; > 30 d). Of 1,645 subjects, gastrostomy tube was performed in 196 (11.9%) and tracheostomy in 56 (3.4%). Factors independently associated with gastrostomy tube placement were DiGeorge syndrome, congenital airway anomaly, admission age less than or equal to 2 days, vocal cord paralysis, cardiac catheterization, infection, and failure to thrive. Factors independently associated with tracheostomy congenital airway anomaly, truncal valve surgery, and cardiac catheterization. Gastrostomy tube was independently associated with prolonged postoperative LOS (odds ratio [OR], 12.10; 95% CI, 7.37-19.86). Hospital mortality occurred in 17 of 56 patients (30.4%) who underwent tracheostomy versus 147 of 1,589 patients (9.3%) who did not ( p < 0.001), and median postoperative LOS was 148 days in patients who underwent tracheostomy versus 18 days in those who did not ( p < 0.001). Tracheostomy was independently associated with mortality (OR, 3.11; 95% CI, 1.43-6.77) and prolonged postoperative LOS (OR, 9.85; 95% CI, 2.16-44.80).
Conclusions:
In infants undergoing truncus arteriosus repair, tracheostomy is associated with greater odds of mortality; while gastrostomy and tracheostomy are strongly associated with greater odds of prolonged postoperative LOS.
More Related Videos
Related Concept Videos
01:28Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:21Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
01:23Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:16Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...