Long-term outcomes of tracheostomy in patients with congenital diaphragmatic hernia

Data on long-term follow-up after tracheostomy in patients with congenital diaphragmatic hernia (CDH) are limited. We assessed current tracheostomy status and clinical characteristics in relation to decannulation during long-term follow-up.

In this multicenter retrospective study, we analyzed the Japanese CDH Study Group database records from 2006 to 2023. Clinical characteristics of patients undergoing tracheostomy during hospitalization were reviewed. Using long-term follow-up data, decannulation status was assessed and decannulation rates were estimated via Kaplan-Meier analysis.

We included 1284 patients, 38 of whom underwent tracheostomy during hospitalization. Compared with the non-tracheostomy group, the tracheostomy group had higher rates of severe cardiac anomalies (21% vs. 9%), more chromosomal abnormalities (26% vs. 7%), greater gestational age (median 37w6d vs. 37w1d), and lower birth weight (median 2468 g vs. 2704 g). Survival among the tracheostomy cohort was 74.4%, 63.7%, and 53.1% at 6, 9, and 12 years, respectively. The cumulative decannulation rate at age 6 years was 36%. Pulmonary vasodilator use at discharge was significantly more common in non-decannulated patients.

Among all CDH infants, 3.0% required tracheostomy. The cumulative decannulation rate at 6 years was 36%. Pulmonary vasodilator use at discharge was more common in non-decannulated patients.