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Pediatric tracheostomy: A large single‐center experience
Author(s) -
Roberts Jessica,
Powell Jason,
Begbie Jacob,
Siou Gerard,
McLar Claire,
Welch Andrew,
McKean Michael,
Thomas Mathew,
Ebdon AnneMarie,
Moss Samantha,
Agbeko Rachel S.,
Smith Jonathan H.,
Brodlie Malcolm,
O'Brien Christopher,
Powell Steven
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28160
Subject(s) - medicine , interquartile range , cohort , single center , subglottic stenosis , retrospective cohort study , pediatrics , mechanical ventilation , pediatric intensive care unit , surgery , emergency medicine , airway , anesthesia
Objectives To describe the epidemiology, specifically the indications, complications, and outcomes, of pediatric tracheostomies performed in one tertiary referral unit. Methods Single‐center retrospective cohort study of pediatric patients undergoing tracheostomy between May 2010 and May 2018 at the Newcastle upon Tyne Hospitals, United Kingdom. Results One hundred seventy‐two pediatric tracheostomies were performed during the study period with a median age of 141 (interquartile range [IQR] 51–484) days. The most common primary indication was long‐term ventilation (38.4%, 66 of 172), followed by weaning from ventilation in cardiac patients (22.1%, 38 of 172). Only 5.2% (9 of 172) of our cohort underwent tracheostomy for subglottic stenosis. The vast majority of tracheostomies were performed electively, with just 6.4% (11 of 172) performed as an emergency procedure. Early and late complication rates were 9.8% (15 of 153) and 40.0% (61 of 153), respectively. Tracheostomy decannulation was successful in 44.4% of children (68 of 153). The median duration the tracheostomy was in situ was 397 (IQR 106–708) days. All‐cause mortality was 22.1% (38 of 172), with tracheostomy‐related mortality at 1.2% (2 of 172). Conclusion We report one of the largest contemporary case series of pediatric tracheostomies. Present‐day pediatric tracheostomy is primarily performed as an elective procedure in ventilated children under the age of 1 year. Pediatric tracheostomy should be considered as a long‐term intervention in many children. Nevertheless, a large proportion of children are ultimately decannulated. It is important to acknowledge the significant morbidity associated with this intervention and the small‐but‐present risk of tracheostomy‐related mortality. Level of Evidence 4 Laryngoscope , 130:E375–E380, 2020