The Turkish Journal of Pediatrics
2011 , Vol 53 , Num 5
Pediatric Tracheotomy: 3-Year Experience at a Tertiary Care Center with 54 Children
1Department of Otolaryngology and Head and Neck Surgery and 2Pediatric Intensive Care Unit, Department of Pediatrics,
Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
The aim of this study was to evaluate the indications, complications and
outcomes of pediatric tracheotomies at a tertiary care center. Data were
obtained retrospectively from 54 patients who underwent tracheotomy from
July 2007 to May 2010. Over the three-year period, 54 tracheotomies were
performed. Thirty-two patients (59.3%) were male and 22 (40.7%) were
female. The mean and median ages of the patients were 54 and 14 months (6
days-17 years), respectively. Twenty-six patients (48.1%) were under 1 year of
age. The most common indication for tracheotomy was prolonged intubation
(87%), followed by upper airway obstruction (13%). Five patients (9.2%)
underwent tracheotomy under semiurgent settings. The overall complication
rate was 29.6% (16/54). Early complications occurred in 7 patients (13%),
including accidental decannulation in 2 patients, subcutaneous emphysema
in 4 patients and hemorrhage in 1 patient. Late complications occurred in
9 patients (16.7%) (stomal granulation in 7 patients and stomal infection
in 2 patients). Eight patients (14.8%) were decannulated successfully. No
tracheotomy-related deaths occurred, with an overall mortality rate of 27.7%
(15/54). Pediatric tracheotomy is a relatively safe procedure with a low
incidence of procedure-related morbidities. The indication for the majority of
the procedures was prolonged intubation (87%). The lower decannulation rate
is related to the higher percentage of patients needing assisted ventilation
and the relatively short follow-up period.
Keywords :
pediatric tracheotomy, indications, complications, outcome.