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The Safety of Pediatric Bedside Tracheostomy

Ory Madgar1,2, Reut Kassif Lerner3, Stav Devons-Sberro4

  • 1Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.

The Annals of Otology, Rhinology, and Laryngology
|May 7, 2024
PubMed

Insights

Pediatric bedside tracheostomy in the intensive care unit (ICU) is safe and effective. This procedure offers similar outcomes and complication rates to traditional operating room tracheostomies for critically ill children.

Area of Science:

  • Pediatric Surgery
  • Critical Care Medicine
  • Otolaryngology

Background:

  • Pediatric tracheostomy is traditionally performed in an operating room due to perceived technical difficulty and high complication rates.
  • Bedside tracheostomy is common in adults but less reported in pediatric intensive care units (ICUs).
  • Transporting critically ill pediatric patients requiring life support systems poses significant risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of performing pediatric tracheostomy at the bedside in an ICU setting.
  • To compare outcomes of bedside pediatric tracheostomy with those performed in an operating room.

Main Methods:

  • Retrospective analysis of pediatric tracheostomies performed at a tertiary care center.
  • Data collected from January 1, 2013, to December 31, 2019.
  • Comparison of outcomes between bedside and operating room tracheostomy groups.

Main Results:

  • 117 pediatric patients underwent tracheostomy; 57 (48.7%) bedside, 60 (51.3%) in the OR.
  • Ages ranged from 2 weeks to 17 years (median 16 months).
  • No bedside cases required transfer to the OR; no significant difference in 30-day morbidity or mortality between groups.

Conclusions:

  • Pediatric open bedside tracheostomy in the ICU is a safe and effective procedure.
  • Outcomes and complication rates are comparable to those of operating room tracheostomies.
  • Bedside tracheostomy can be a viable alternative for select pediatric patients in the ICU.
Abstract

Keywords:
bedside proceduresbedside tracheostomypediatric tracheostomytracheostomytracheotomy

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