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Tracheostomy in childhood: 20 years experience from a pediatric surgery clinic
Author(s) -
İlçe Zekeriya,
Celayir Sinan,
Tekand GoncaTopuzlu,
SarI Murat Nüvit,
ErdoĞan Ergun,
Yeker Daver
Publication year - 2002
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1442-200x.2002.01554.x
Subject(s) - medicine , tracheotomy , surgery , subglottic stenosis , tracheomalacia , mechanical ventilation , complication , intubation , airway , respiratory failure , anesthesia
Background: There is a limited indication for tracheostomy procedures in pediatric surgery. It is rarely applied to the pediatric patient because they can be kept intubated for a longer duration compared with adults. Problems and complications can occur after tracheostomy, even during the childhood period.Purpose: The purpose of this study is to evaluate our experience with tracheostomy procedure.Methods: Records of 17 children treated over a 20‐year period (1978−99) were reviewed retrospectively in the aspects of indication, complication and mortality.Results: There were 13 boys and four girls witha mean age 30.3 months (range: 1 week−13 years).Indications for tracheostomy were prolonged intubation ( n = 5),subglottic stenosis ( n = 3), generalbody trauma ( n = 2), tracheomalasia( n = 2), tracheoesophageal cleft( n = 1), cervical tumor pressingtrachea and larynx ( n = 1), congenitalmyotonic dystrophy plus respiratory failure ( n = 1),burn injury of trachea and esophagus ( n = 1), andforeign body aspiration ( n = 1). In the last decade the number of cases with tracheotomy increased due to the development of new intensive care units, the use of mechanical ventilation and the increasing number of patients needing prolonged ventilation support. In this group, tracheostomies were mainly performed electively. The overall complication rate was 29%. Mortality was 59% and there was one death related to the tracheostomy procedure.Conclusion: Tracheostomy is a life saving procedure when performed with an appropriate indication and surgical technique. Therefore, the pediatric surgeons dealing with this procedure should be aware of the tracheostomy care problems, fatal complications and the need for reconstructive surgery. With strict indications and experience of the procedure, this should be enough effort to minimize its complications and related care problems.