Tracheostomy in children: A population-based experience over 17 years

Mohammed Al-Samri, Ian Mitchell, Derek S. Drummond, Candice Bjornson

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)

Abstract

Introduction: Tracheostomy is a lifesaving intervention with numerous complications. Objectives: We describe the natural history of tracheostomy in children in a defined geographical area over a 17-year period. Our primary aim is to stress the need for a consensus on pediatric tracheostomy care. Methods: This retrospective study reviewed the charts of 72 children who had tracheostomy between January 1990 and January 2007. Indications for the procedure were divided into 3 groups: (1) upper airway obstruction at a well-defined anatomic site (32 patients); (2) upper airway obstruction with a complex medical condition (24 patients); and (3) need for an access to the lower airway for long-term ventilation and pulmonary care with normal airway anatomy (16 patients). Results: The most common indication for tracheostomy was upper airway obstruction due to subglottic stenosis (15 patients, 21%) or as part of a complex craniofacial syndrome (15 patients, 21%). The duration of intubation prior to tracheostomy and the duration of hospitalization after tracheostomy varied markedly. Tracheocutaneous fistulae complicated 15 of the 38 (37%) decannulated patients. Tracheostomy infection occurred in 90% of the patients and tracheal granulation in 56%. Eleven (15%) deaths occurred, 10 were due to the underlying medical illness and 1 to a mucous plug. Conclusion: The complications of tracheostomy in children are substantial. Surveillance and prompt interventions are necessary to overcome life-threatening sequelae. A multidisciplinary (medical-surgical) approach provides better care for these highly vulnerable children. A consensus on pediatric tracheostomy care is needed.

Original languageEnglish
Pages (from-to)487-493
Number of pages7
JournalPediatric Pulmonology
Volume45
Issue number5
DOIs
Publication statusPublished - May 2010

Keywords

  • Airway disease
  • Airway infection
  • Long-term ventilation
  • Mucous plug
  • Tracheostomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Fingerprint

Dive into the research topics of 'Tracheostomy in children: A population-based experience over 17 years'. Together they form a unique fingerprint.

Cite this