Tracheostomy Related Adverse Events: Is There a Weight-Related Association in Pediatric Patients

Area of Science:

• Pediatric Otolaryngology
• Tracheostomy Management
• Pediatric Critical Care

Background:

• Adults show increased tracheostomy complication risk with higher body mass.
• The association between pediatric weight status and tracheostomy complications is not well-established.
• Understanding this relationship is crucial for optimizing pediatric airway management.

Purpose of the Study:

• To assess the relationship between weight-for-length percentile (infants) or body mass index (BMI) (children) and adverse tracheostomy events.
• To identify if increased weight status in pediatric patients correlates with a higher incidence of tracheostomy-related complications.

Main Methods:

• Retrospective review of the Global Tracheostomy Collaborative database (2008-2023).
• Included patients under 20 years undergoing tracheostomy at a tertiary center.
• Analyzed weight-for-length percentiles/BMI percentiles against adverse events using logistic regression.

Main Results:

• Of 474 patients, 20.2% experienced at least one adverse tracheostomy event.
• Common complications included skin issues, bleeding, granulation tissue, decannulation, and tube obstruction.
• No statistically significant association was found between higher weight-for-length/BMI percentiles and adverse events (p > 0.05).

Conclusions:

• Neither higher weight-for-length percentiles in infants nor increased BMI in children significantly increased tracheostomy adverse events.
• Observed trends of higher complication rates in overweight/obese children warrant clinical concern.
• Larger-scale investigations are recommended to further explore this potential association.