Abstract
Purpose. This paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital, Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications, and decannulation time were all assessed. Results. Fifty-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy between 2006 and 2013 were investigated. The most common indication for tracheostomy was upper airway obstruction (66.7%), followed by prolonged intubation (33.3%). Mean decannulation times after tracheostomy ranged between 1 and 131 days, the difference being statistically significant (P=0.040). There was no significant difference in terms of mean age (9.8±6.0; P=0.26). There was also no statistical difference between emergency and planned tracheotomies (P=0.606). Conclusion. In our patient population, there was a significant decline in the number of tracheotomies performed for prolonged intubation and an increasing number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were slightly higher with an increase in genetic diseases such as neuromuscular disease.
Highlights
Tracheotomy is one of the most frequent planned therapeutic or emergency surgical procedures in critically ill patients
The infant larynx is hidden by the hyoid bone, since it occupies a higher position in the neck than in adults
We determined no significant differences between emergency and planned tracheotomies (P > 0.05)
Summary
Tracheotomy is one of the most frequent planned therapeutic or emergency surgical procedures in critically ill patients. Pediatric tracheotomy was first performed in 1620 [1]. 200 tracheotomies were performed by Trousseau due to diphtheria with airway obstruction in 1833 [2]. Upper airway obstruction, prolonged ventilator dependence, and hypotonia secondary to neurological impairment are some of the most common indications for tracheotomy in pediatric patients. The small diameter of the infant larynx and trachea means that minor changes due to mucosal edema can quickly lead to severe and even life threatening narrowing of the airway. Cricoid cartilage is often prominent, and palpation to establish the level of the airway can sometimes be difficult. These anatomical characteristics that differ from those in adults may make management more problematic
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