Description of the patients with tracheostomy discharged from the Intensive Care Service of the National Children´s Hospital. (January 1996 – December 2007)

Abstract

Aim: Tracheostomy is a surgical procedure used in the management of the airway in pediatric and neonatal patients. The aim of this study was to describe the epidemiological characteristics, clinical indications and complications of tracheostomized children discharged from the Neonatal Intensive Care Service of the National Children’s Hospital “Dr. Carlos Sáenz Herrera” (HNN). Methods: We made a retrospective review, with the clinical records of all those children who underwent tracheostomy and were discharged from the Neonatal Intensive Care Service of HNN in the period between January 1996 and December 2007. Results: During the study period, 48 patients were discharged with a tracheostomy. The average number of tracheostomy performed per year was 3.9. The average birth weight was 2192 g. The average age at which the tracheostomy was performed was 44 days. The main indication for tracheostomy was prolonged mechanical ventilation because of bronchopulmonary dysplasia in 23 patients. The tracheostomy-related complications occurred in 40.4% of cases. A total of 29 patients (61.3%) were discharged alive and 18 died (38.8%). Conclusions: Most patients who underwent tracheostomy were preterm (61.7%) and with a birth weight less than 2500 g (57.44%). The main indicators for tracheostomy were bronchopulmonary dysplasia, myopathies, subglottic stenosis, hemangioma, craniofacial anomalies and malacia. The main early complications were cannula obstruction, accidental decannulations and wound complications. The most common late complications were granulomas and cannula obstruction.No study patient had complications associated with tracheal tube that could cause his death.