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Tracheostomy in children

B Simma1, D Spehler, R Burger

  • 1Intensive Care Unit, University Children's Hospital, Zürich, Switzerland.

European Journal of Pediatrics
|April 1, 1994
PubMed

Insights

Tracheostomy is a safe procedure for children, even infants, with a low mortality rate. However, cannula-related complications can be life-threatening, necessitating intensive care management.

Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Critical Care Medicine

Background:

  • Tracheostomy is a surgical procedure to create an airway.
  • Indications for tracheostomy in children include subglottic stenosis, vocal cord paralysis, and congenital airway malformations.
  • Previous reviews indicate varying safety profiles and complication rates.

Purpose of the Study:

  • To evaluate the safety and efficacy of tracheostomy in pediatric patients.
  • To identify common indications and complication patterns.
  • To assess the impact of intensive care unit management on outcomes.

Main Methods:

  • Retrospective review of 108 pediatric patients undergoing tracheostomy between July 1979 and April 1989.
  • Analysis of patient demographics, surgical indications, intraoperative events, and postoperative complications.
  • Evaluation of decannulation rates, hospital stay, and mortality.

Main Results:

  • The most common indications were acquired subglottic stenosis (31.4%) and bilateral vocal cord paralysis (22.2%).
  • Postoperative pneumothorax occurred in 7.4% of patients.
  • Severe complications during cannulation (19.5%) and after decannulation (13.8%) were noted, including tube obstruction and dislocation.
  • Successful decannulation was achieved in 78.7% of patients.
  • No deaths were directly related to the tracheostomy procedure.

Conclusions:

  • Tracheostomy is a safe procedure in pediatric patients, including infants, with a lower mortality rate than previously reported.
  • Cannula-related complications, such as obstruction and dislocation, can be life-threatening.
  • Management in a well-staffed intensive care unit improves complication handling and reduces mortality.

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