Pediatr Allergy Respir Dis.  2012 Jun;22(2):188-196.

Causes and Outcome of Tracheostomy in Children

Affiliations
  • 1Department of Pediatrics, Sahmyook Medical Center, Seoul, Korea.
  • 2Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.
  • 3Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 4Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kmaped@skku.edu

Abstract

PURPOSE
Tracheostomy is used to aid airway management in perdiatric respiratory care. This study was designed to review causes and outcomes of pediatric tracheostomy.
METHODS
We performed a retrospective chart review of 153 patients, less than 18 years of age, who underwent tracheostomy between January 1995 and July 2010. Age at tracheostomy, indications, durations, complications and mortality were evaluated.
RESULTS
Subglottic stenosis (19%) was the most common indication for tracheostomy. The median age at tracheostomy was 1.3 years (range, 22 days to 17.8 years). Seventy-three (47.7%) tracheostomies were performed in children under 1 year of age. Respiratory diseases were significantly more prevalent in patients under 1 year of age, while neuromuscular disease were more frequently found in patients older than 1 year (P=0.013). Stoma or tracheal granuloma formation (36.6%) was the most common complication of pediatric tracheostomy. Decannulation was accomplished in 61 (39.9%) patients with median cannulation time of 141 days (range, 1 to 2,529 days). Overall mortality rate was 10.5% (n=16), but only one patient (0.7%) died from tracheostomy-related complications.
CONCLUSION
Respiratory diseases, such as subglottic stenosis and neuromuscular disease, are the main cause of pediatric tracheostomy. Although complications, like stoma or tracheal granuloma formation occur, tracheostomy in children is a safe way to aid airway management.

Keyword

Tracheostomy; Children; Airway management; Complications

MeSH Terms

Airway Management
Catheterization
Child
Constriction, Pathologic
Granuloma
Humans
Neuromuscular Diseases
Retrospective Studies
Tracheostomy

Figure

  • Fig. 1 Age at time of tracheostomy.

  • Fig. 2 Age at time tracheostomy younger than 1 year.


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