Outcome in pediatric tracheotomy

• Published in: American journal of otolaryngology 2003-05, Vol.24 (3), p.131-137
• Main Authors: Tantinikorn, Weerachai, Alper, Cuneyt M., Bluestone, Charles D., Casselbrant, Margaretha L.
• Format: Article
• Language: English
• Subjects: Airway Obstruction - therapy; Biological and medical sciences; Child, Preschool; Female; Follow-Up Studies; Humans; Intubation, Intratracheal; Male; Medical sciences; Postoperative Complications - epidemiology; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Time Factors; Tracheotomy; Treatment Outcome
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/S0196-0709(03)00009-7

Objective: To investigate the outcome and related factors in pediatric tracheotomy. Design: Retrospective chart review. Setting: Tertiary pediatric academic hospital setting. Patients: The study included 181 children below the age of 18 years who underwent 185 tracheotomies between 1991 and 1995. Main Outcome Measures: Presenting symptoms and signs, indications, duration of follow-up, therapeutic and interval procedures, early and late complications, mortality, time to and success in decannulation. Results: There were 108 (59.7%) male patients and 73 (40.3%) female patients. The average age of the children at the time of tracheotomy was 3.8 ± 5.3 years. The majority of the children were less than 1 year of age (n = 99, 54.7%). Airway obstruction was the leading indication for tracheotomy (59.6%), followed by ventilatory support (30.4%) and pulmonary toilet (9.9%). The average duration of follow-up was 931 ± 790 days. There were no perioperative complications. Early postoperative complications were seen in 28 (15.5%) children including 12 (6.8%) major complications and 22 (12.2%) minor complications. Late complications were seen in 115 (63.5%) children, including 8 (4.4%) major complications and 107 (59.1%) minor complications. Overall mortality rate was 13.3%, but only 1 tracheotomy-related death was caused by tube displacement. Therapeutic procedures were performed in 43% of the children, including laryngotracheal reconstruction (13%), laser excision of the lesion (5%), and supraglottoplasty (3.9%). Decannulation was accomplished in 116 (64.1%) of the children with an average of 365 ± 388 days with tracheotomy. Conclusion: Tracheotomy is relatively safe in the pediatric population. Decannulation may be possible relatively quickly with resolution of the underlying problem.