Pediatric Tracheostomy: A Five-year Retrospective Review at a Tertiary Care Center

Tracheostomy in the pediatric population is a technical and demanding procedure due to the smaller, more pliable trachea and the limited exposure of the operating field. It has been documented to have higher morbidity and mortality, especially among low birth weight and pre-term infants. A review of the existing literature shows that indications, epidemiology, and complications are changing dynamically, and no definite guidelines have been established.

A five-year retrospective observational study on pediatric tracheostomy was carried out at a pediatric tertiary care center. All children aged between 1 day and 18 years who had undergone tracheostomy were included. Case records of all children were analyzed meticulously for age, sex, indications, procedure, and complications of tracheostomy.

During the study period, 148 children underwent tracheostomy at our pediatric tertiary care center. The most common indication for tracheostomy was neurological causes, noted in 77 patients (52.02%). The most common early postoperative complication was tube obstruction in 13 patients (8.78%), and the most common delayed postoperative complication was suprastomal collapse in 52 patients (35.13%). In total, 104 patients (70.27%) underwent successful decannulation.

Pediatric tracheostomy is a very demanding and challenging procedure owing to the alterations in the neck anatomy, variations in the airway, and several associated complications. There is a growing need to know the change in indications, complications, and overall outcome of pediatric tracheostomies for better care and efficient management of children requiring tracheostomies.