Causes and Outcome of Tracheostomy in Children

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. [Pediatr Allergy Respir Dis(Korea) 2012;22:188-196]