Long-term Intubation Research Articles

Comparison of the Consequences of Short vs. Long-Term Intubation on Speech and Swallowing.

Introduction: Intubated, ventilator unweanable patients with ventilatory pump failure (VPF) can be extubated to continuous noninvasive positive pressure ventilatory support (CNVS), however, delays may result in untoward effects on speech and swallowing.Methods: Retrospective chart review of VPF patients to determine need for post-extubation gastrostomy tubes (GTs) and consequences on speech for intubations less than (short) vs. greater than (long) three weeks.Results: 165 patients were intubated for a mean 20.7 ± 23.5 (range = 1 to 240) days. All recovered pre-hospitalization speech status within two hours to 3 days. 104 of the short group were intubated 1.6 ± 1.3 (range = 1 to 9) times for 9.9 ± 5.1 (range = 1 to 20) days vs. 61 of the long group intubated 2.4 ± 3.3 (range = 1 to 26) times for 39.0 ± 30.5 (range = 21 to 210) days. 10.6% vs. 8.2%, respectively, required post-extubation GTs indefinitely.Discussion: There was no difference in untoward effects on speech or swallowing from short vs. long-term intubation. Had the patients undergone tracheotomies, the majority would have had GTs placed permanently and suffer morbidity and mortality from the tubes. Thus, an option is to permit patients to remain intubated, and even if unweanable, extubate them to CNVS rather than tracheotomy.

Application of acellular dermal matrix in prevention of laryngeal stenosis in glottic carcinoma

Objective:To investigate the effect of acellular dermal matrix in preventing laryngeal stenosis in glottic carcinoma patients. Methods:Fifty-five patients with glottic carcinoma（T2, T3） from February 2018 to December 2022 were divided into experimental group（28 cases） and control group（27 cases） according to their wishes. Acellular dermal matrix was placed in the operation cavity in the experimental group after laryngofission, while control group 12 cases were sutured by pulling the upper and lower edges, 15 cases were repaired with sternohyoid muscle fascia flap. Results:In the experimental group, 1 case had laryngeal stenosis caused by laryngeal mucosa swelling after operation, and extubated successfully after symptomatic treatment. In the control group, 7 cases had laryngeal stenosis after operation, of which 3 cases were caused by granulation tissue hyperplasia in laryngeal cavity, and extubated after symptomatic treatment. 2 cases extubated after operation suffered from progressive dyspnea during radiotherapy, and underwent tracheotomy again, extubation successful after treatment. 2 cases caused by laryngeal mucosa swelling, after symptomatic treatment, one case was successfully extubated, and one case had long-term intubation. The laryngeal stenosis rate of the experimental group was 3.6%（1/28） , which was lower than control group 25.9%（7/27）, and the therapeutic effect of the experimental group was significantly better than control group （χ²=5.526, P=0.019）. Conclusion:Implanting acellular dermal matrix in the operation cavity of glottic carcinoma can reduce the occurrence of laryngeal stenosis and have satisfactory preventive effect on laryngeal stenosis.

Problems Related to Endotracheal Intubation as an Input for the Design of a New Endotracheal Tube.

The purpose of the current review is to identify the main problems of endotracheal intubation, which will serve as a basis for the design requirements for a novel endotracheal tube. A PICO systematic search was conducted in PubMed up to December 2021 to identify issues related both to the endotracheal intubation procedure and device-specific factors. Two primary categories of problems were identified during endotracheal intubation: a) Issues related to laryngotracheal symptoms such as cough, hoarseness, aphonia, dysphonia, dysphagia, swallowing difficulties and the risk of stenosis with long-term intubation. The underlying pressure, abrasion and/or decubitus phenomena should be considered in a new design approach. b) Issues related to the cuff sealing and microaspirations, where the risk of ventilator-associated pneumonia (VAP) highlights the need to improve the design. This review has yielded valuable input for rethinking the design of endotracheal tubes to ensure an efficient and safe airway. This new design should focus on the protection of anatomical structures, avoid or reduce the phenomena of laryngotracheal symptoms, and even reduce the risk of ventilator-associated-pneumonia (VAP) and/or prevent the need for certain tracheostomies.

Surgical treatment of sacral pressure injury in ambulating patients during the COVID-19 pandemic: A prospective cohort with complications analysis and elaboration of a surgical treatment protocol

The sudden increase of intensive care unit patients during the coronavirus pandemic led to an increase in the incidence of sacral pressure lesions. Despite being ambulating patients, in many cases the lesions were deep (Grade III and IV), mainly due to the long-term intubation and being bedridden during the pandemic. Most of these wounds necessitated surgical repair. To measure the success and the rate of complications in reconstructions of grade III and IV hospital acquired sacral pressure lesions in ambulating patients after hospitalization for COVID-19. Developing a well-established protocol for surgical treatment of hospital acquired sacral pressure lesions during the COVID-19 pandemic. Prospective cohort involving ambulating patients with grades III and IV sacral pressure lesions developed after hospitalization for COVID-19 from May 2020 to August 2020 (4 months). All of them were submitted to reconstruction with fasciocutaneous flaps. Demographics, comorbidities, and preoperative laboratory tests were compared and multivariable-adjusted logistic regression was made in order to identify risk factors for complications. Thirty-eight patients were submitted to fasciocutaneous flaps to repair sacral pressure lesions with a total complication rate of 36.0%. Hemoglobin levels lower than 9.0mg/dl (p=0,01), leukocyte levels higher than 11.000/mm3 (p=0,1), and C Reactive protein levels higher than 142mg/dl (p=0,06) at the time of reconstruction and bilateral flaps were independent factors for complications. Specific preoperative laboratory tests and surgical techniques were associated with a statistically significant increased complication risk. It was established a protocol for surgical treatment of hospital-acquired sacral pressure lesions to diminish these risks, focusing on ambulating patients during the COVID-19 pandemic.

Numerical simulation of the effect of geometric parameters on silicone airway stent migration

Recently, endotracheal stenting has become critical in treating respiratory diseases. Due to the COVID-19 pandemic in recent years, many patients had stenosis because of long-term intubation, and silicone stents can be used to treat tracheal stenosis in these patients. Standard airway stents are silicone tubes that provide immediate relief but are prone to migration. In this work, we design different silicone stents and analyze them in the trachea to evaluate silicone airway stents’ performance to overcome undesired migration. A finite-element model of the trachea was employed to evaluate anti-migration forces in each stent. The geometry of the trachea is brought from a computerized tomography scan of the chest of a 68-year-old healthy man. The results are shown based on the least migration of stents based on anti-migration forces. Also, the conditions of stent placement have been considered based on two different assumed friction factors, and the importance of choosing the type of silicone for stent construction has been analyzed. The results show that increasing the diameter of the stent reduces the displacement and migration of it in the trachea. Furthermore, the 23 mm stent with a 45° angle revealed the best implementation against compression under the impact of respiratory pressure differences.

Design and fabrication of silicone-silica nanocomposites airway stent

Introduction: Due to the COVID-19 pandemic in recent years, many patients after extubation had stenosis in all tracheal areas because of long-term intubation. Therefore, tracheal stenosis in these patients is benign and can be treated using silicone stents, and many patients need silicone stents during recovery. A silicone stent is an artificial support that plays a significant role in managing airway obstruction.Methods: This research aims to fabricate an optimal silicone stent reinforced with Nanosilica by vacuumed injection molding. Materials-based nanocomposites are made of rtv2 silicone with 1wt%, 3wt%, and 5wt% of hydrophilic and hydrophobic Nanosilica particles. Hardness, tensile, and hydrophobicity properties have been performed for the experimental characterization of the nanocomposites.Results and Discussion: The uniform distribution of nanoparticles in the silicone matrix has been confirmed using SEM images. Adding Nano-silica increases hardness and tensile strength and improves the silicone matrix’s mechanical properties. Also, the addition of nanoparticles changes the surface hydrophobicity properties and roughness. Although the presence of nanoparticles improves the mechanical properties, it also reduces the transparency and increases the viscosity. Our results show that adding 1wt%. Hydrophobic Nano-silica improves nanocomposites’ mechanical properties and preserves transparency and viscosity (mold-ability) for stent construction. Adding 3wt%. Hydrophilic Nano-silica improves mechanical and hydrophobic properties, but moldability is not easy. Finally, the fabricated nanocomposite airway stents were successfully placed on the sheep trachea in the pilot animal study.

A Case of Posterior Glottic Stenosis Caused by Treatment of COVID-19 with Long-term Intubation

Posterior glottic stenosis (PGS), of which the most common cause is tracheal intubation, is often misdiagnosed as bilateral vocal cord paralysis. We herein report a case of PGS that occurred after treatment with COVID-19 with long-term intubation. The patient underwent tracheostomy and endoscopic resection and showed improvement in dyspnea. The COVID-19 epidemic is expected to increase long-term intubation cases and cases of severe laryngeal injury, including PGS. We need tracheostomy in long-term intubated COVID-19 patients, just like other diseases, and an appropriate diagnosis and surgical treatment for PGS should be performed. When otolaryngologists encounter cases of bilateral vocal cord paralysis, it is necessary to keep in mind the possibility of PGS and laryngeal stenosis and pay attention to the history of COVID-19.

Therapeutic outcomes of laryngeal closure and laryngostomy in children with recurrent pneumonia

PurposeChildren with medical complexity frequently experience difficulty breathing and swallowing and occasionally develop aspiration pneumonia. Long-term intubation may cause fatal trachea-innominate artery fistula (TIF). In the present study, we retrospectively evaluated the efficacy of laryngeal closure and laryngostomy in children with medical complexity. Materials and methodsLaryngeal closure and laryngostomy were performed in eight children with severe neuromuscular disorders who were incapable of oral ingestion and verbal communication. The laryngostoma was placed at a higher position compared to that in conventional tracheostomies for easier management of the airway and to prevent TIF. ResultsAspiration was successfully prevented postoperatively in all cases. Laryngocutaneous fistula formation was not observed. Two patients successfully achieved oral ingestion capability and tracheal cannulas were removed in two patients. Among the six patients who needed a mechanical ventilator before surgery, two patients were weaned from mechanical ventilation. Five patients were successfully discharged from the hospital. Although two patients died because of their primary condition, pneumonia exacerbation was not observed in any of the patients. ConclusionCompared to the conventional tracheostomy, our procedure improved airway management and function in children with medical complexity and reduced the risk of TIF.

A Randomized Controlled Trial to Evaluate the Use of Probiotics in Prevention of Ventilator-Associated Pneumonia in Critically Ill ICU Patients

Abstract Context Ventilator-associated pneumonia (VAP) is one of the most common causes of morbidity and mortality in mechanically ventilated patients. Curing and preventing effects of probiotics in promoting the growth of Bifidobacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of VAP are evident. Aims The purpose of this study was to evaluate the effects of administration of commercially available probiotics, that is, orodispersible probiotic sachets on VAP prevention and clinical outcomes in critically ill patients. Settings and Design Randomized control trials. Methods and Materials In this study, 120 mechanically ventilated patients were randomly divided into two groups (n = 60 per group). Group 1 was given orodispersible probiotic sachets by gavage, twice a day in addition to routine care, while group 2 received only routine care. Demographic and clinical data were analyzed and clinical outcomes to the primary component (prevalence of VAP) and secondary component (other clinical factors) were interpreted. Statistical Analysis Used In this study, data were analyzed via SAS statistical software version 9.4, using Student's t-test, chi-squared test, repeated measure analysis of variance, and Wilcoxon test. Results There was a significant reduction in VAP diagnosed patients, as well as Clostridium difficile-associated diarrhea and some complications of mechanical ventilation, in group 1 in comparison to group 2. The improvement in VAP was significantly greater for group 1 as compared with group 2. However, the mortality rate was similar between two groups. Conclusions This study demonstrated that a daily diet with orodispersible probiotic sachets can be used as add-on therapy with other medications in the prevention of VAP. As a result, the use of orodispersible probiotic sachets in the treatment plan of patients undergoing long-term intubation is recommended.

Perioperative Oral Management Prevents Complications of Heart Valve Surgery

ObjectivesThe effect of perioperative oral management on the prevention of postoperative complications remains unclear in cardiac surgery. Exploratory factor analysis was performed to examine whether a lack of perioperative oral management was associated with postoperative complications of heart valve surgery. Materials and methodsWe retrospectively enrolled 365 patients who underwent heart valve surgery between April 2010 and March 2019. We extracted data on patient characteristics and set postoperative pneumonia and postoperative bloodstream infection as outcomes. A logistic regression analyses were performed to examine the effect of factors on the incidence of postoperative complications. ResultsSignificant risk factors for postoperative pneumonia included dialysis, long operative time, and long-term intubation. Similarly, risk factors for postoperative bloodstream infection were long-term intubation and lack of perioperative oral management. Subsequently, we identified the risk factors for long-term intubation, which were common to both complications, and found they were emergency status, combined valvular disease, long operative time, and lack of perioperative oral management. ConclusionsWe demonstrated that a lack of perioperative oral management could be a risk factor for postoperative bloodstream infection and long-term intubation in heart valve surgery. The results suggest that perioperative oral management is effective in preventing postoperative complications of heart valve surgery.

A novel antibacterial and antifouling nanocomposite coated endotracheal tube to prevent ventilator-associated pneumonia

BackgroundThe endotracheal tube (ETT) is an essential medical device to secure the airway patency in patients undergoing mechanical ventilation or general anesthesia. However, long-term intubation eventually leads to complete occlusion, ETTs potentiate biofilm-related infections, such as ventilator-associated pneumonia. ETTs are mainly composed of medical polyvinyl chloride (PVC), which adheres to microorganisms to form biofilms. Thus, a simple and efficient method was developed to fabricate CS-AgNPs@PAAm-Gelatin nanocomposite coating to achieve dual antibacterial and antifouling effects.ResultsThe PAAm-Gelatin (PAAm = polyacrylamide) molecular chain gel has an interpenetrating network with a good hydrophilicity and formed strong covalent bonds with PVC-ETTs, wherein silver nanoparticles were used as antibacterial agents. The CS-AgNPs@PAAm-Gelatin coating showed great resistance and antibacterial effects against Staphylococcus aureus and Pseudomonas aeruginosa. Its antifouling ability was tested using cell, protein, and platelet adhesion assays. Additionally, both properties were comprehensively evaluated using an artificial broncho-lung model in vitro and a porcine mechanical ventilation model in vivo. These remarkable results were further confirmed that the CS-AgNPs@PAAm-Gelatin coating exhibited an excellent antibacterial capacity, an excellent stain resistance, and a good biocompatibility.ConclusionsThe CS-AgNPs@PAAm-Gelatin nanocomposite coating effectively prevents the occlusion and biofilm-related infection of PVC-ETTs by enhancing the antibacterial and antifouling properties, and so has great potential for future clinical applications.Graphical

Pädiatrische Atemwegschirurgie: Indikationen und Techniken

Even in specialised centres, surgical procedures on the airway are only rarely performed in paediatric patients. Moreover, knowledge of various specific anatomical characteristics, diseases and surgical techniques is a prerequisite to treat these patients. Most commonly, sequelae of long-term intubation or tracheostomy in multimorbid patients necessitate surgical repair. Moreover, congenital malformations of the airways might require surgical interventions. However, these are commonly associated with other organ malformations, which adds further complexity to the treatment concept. Thus, cooperation within an interdisciplinary team is absolutely necessary to treat these patients. However, good postoperative outcomes after paediatric airway surgery can be achieved in experienced centres with an appropriate infrastructure. Specifically, this means long-term tracheostomy-free survival with preserved laryngeal functions in most of the patients. This review provides a summary of common indications and surgical techniques in paediatric airway surgery.

Bleeding Complications of a Tracheostomy Stoma Covid-19 Patients Related to Therapy Heparin

Tracheostomy measures will increase as the number of ICU patientsincreases. The main indication for tracheostomy in intensive carepatients is to reduce dead space and reduce the risk of laryngealdamage due to long-term intubation. In the era of the Covid-19pandemic, tracheostomy procedures require consideration of thebenefits for patients and the risk of spreading the virus thatendangers health workers. In this case, it is reported that theimplementation of a tracheostomy with a safe procedure in patientswith severe Covid-19 infection and complications of stoma bleeding6 days after the tracheostomy procedure with risk factors for theuse of heparin anti-coagulant drugs

Nasotracheal vs. Orotracheal Intubation and Post-extubation Airway Obstruction in Critically Ill Children: An Open-Label Randomized Controlled Trial.

Background: The data on long-term nasotracheal intubation among mechanically ventilated critically ill children is limited. The purpose of this study was to compare the rate of post-extubation airway obstruction (PEAO) with nasotracheal and orotracheal intubation.Methods: This open-label randomized controlled trial was conducted in PICU of a tertiary care and teaching hospital in North India from January-December 2020 involving intubated children aged 3 months−12 years. After written informed consent, children were randomized into nasotracheal and orotracheal intubation groups. Post-extubation, modified Westley's croup score (mWCS) was used at 10-timepoints (0-min, 30 min, 1, 2, 3, 6, 12, 24, 36, and 48-h after extubation) to monitor for PEAO. The primary outcome was the rate of PEAO; and secondary outcomes were time taken for intubation, number of intubation attempts, complications during intubation, unplanned extubation, repeated intubations, tube malposition/displacement, endotracheal tube blockade, ventilator associated pneumonia, skin trauma, extubation failure/re-intubation, duration of PICU stay, and mortality.Results: Seventy children were randomized into nasotracheal (n = 30) and orotracheal (n = 40) groups. Both the groups were similar in baseline characteristics. The rate of PEAO was similar between nasotracheal and orotracheal groups (10 vs. 20%, p = 0.14). The maximum mWCS and mWCS at 10-timepoints were similar in two groups. The time taken for intubation was significantly longer (85 vs. 48 s, p < 0.001) in nasotracheal group, whereas other secondary outcomes were similar in two groups.Conclusion: The rate of PEAO was not different between nasotracheal and orotracheal groups.Clinical Trial Registration:http://ctri.nic.in, Identifier: CTRI/2020/01/022988.

Emergence and Genetic Characterization of Plasmid-Encoded VIM-2-Producing Pseudomonas stutzeri with Novel Integron In1998 Isolated from Cerebrospinal Fluid.

PurposeTo investigate the genomic and plasmid characteristics of a newly discovered Pseudomonas stutzeri strain with a blaVIM-2-carrying plasmid and novel integron In1998 isolated from a cerebrospinal fluid specimen in a teaching hospital.MethodsSpecies identification was performed by MALDI-TOF MS, and blaVIM-2 was identified by PCR and Sanger sequencing. Whole-genome sequencing analysis was conducted using the Illumina NovaSeq 6000 and Oxford Nanopore platforms. Integron detection was performed using INTEGRALL. The phylogenetic tree was constructed by using kSNP3.0. Plasmid characteristics were assessed by S1-pulsed-field gel electrophoresis (S1-PFGE), Southern blotting, conjugation experiments, and whole-genome sequencing analysis. Comparative genomics analysis of the plasmid and genetic context of blaVIM-2 were conducted by using BLAST Ring Image Generator (BRIG) and Easyfig 2.3, respectively.ResultsZDHY95, an MDR strain of P. stutzeri harboring blaVIM-2, was identified. It was sensitive only to amikacin and was resistant to carbapenems, β-lactams, aztreonam, fluoroquinolones, and aminoglycosides. Joint S1-PFGE, Southern blot, conjugation assay, and whole-genome sequencing experiments confirmed that the blaVIM-2 gene was located within class I integron In1722 of the plasmid and that the surrounding genetic environment was 5ʹCS-aacA4ʹ-30-blaVIM-2-aacA4ʹ-3ʹCS. The novel class I integron In1998 was detected on the chromosome of P. stutzeri ZDHY95, and the gene cassette array was 5ʹCS-aacA3-aadA13-cmlA8-blaOXA-246-arr3-dfrA27-3ʹCS. Phylogenetic analysis showed that antimicrobial resistance gene-carrying P. stutzeri isolates were divided into two clusters, mainly containing isolates from the USA and Pakistan.ConclusionA novel blaVIM-2-carrying conjugative plasmid, pZDHY95-VIM-2, was reported for the first time in P. stutzeri, elucidating the genetic environment and transfer mechanism. The gene structure of the novel class I integron In1998 was also clarified. We explored the phylogenetic relationship of P. stutzeri with drug resistance genes and suggested that Pseudomonas with metallo-β-lactamases (MBLs) in the hospital environment may cause infection in patients with long-term intubation or after interventional surgery.

Performance of a new recuperative Heat and Moisture Exchange Mask

Aim of the study: The purpose of this work is to show the possibility to use a recuperative design of a heat and moisture exchange face mask (HME). Such HME are used as cold weather face masks for Arctic expeditions and conditioning of air for long-term intubated patients. Common regenerative HME have the disadvantage of increasing airway resistance and airway volume (dead space). In recuperative devices, the separation of inspired and expired airflow could reduce dead space and resistance. Materials and methods: Prototype HMEs were built using two concentric ducts of aluminium or cotton. A valve ensures that expired and inspired air are led through either the inner or the outer tube. The inner tube’s wall transmits heat and water. The HMEs were tested in a simulated Arctic environment using a breathing simulator and characterized in terms of heat and moisture exchange efficiency. The new design was also tested at room temperature in order to simulate the conditions of long-term intubation. To compare the results, the relative difference in temperature (Performance Coefficient PC) between the expired and the inspired air was calculated. Results: During the experiments, the ambient temperature was −37°C and therefore the absolute water content was about zero. The recuperative HME conditioned the air to 21°C and 10.7 mg/l water (61% relative humidity), giving a PC of 82%. At room temperature the recuperative mask showed a PC of 62%. Conclusion: The recuperative HME shows great potential. It might be of use in clinical conditions and Arctic expeditions.

Letter to the Editor regarding “Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society” by Piazza et al.

Letter to the Editor regarding “Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society” by Piazza et al.

Clinical study of swallowing function in infants after long-term intubation without oral intake

Clinical study of swallowing function in infants after long-term intubation without oral intake

Efficiency of Laparoscopic Treatment of the Stricture of the Bowl-ureter Segment in Combination with Urolithiasis

Stricture of the bowl-ureter segment (BUS) is one of the common pathologies in urology. Quite often in urological practice narrowing of BUS is accompanied by urolithiasis. In adults, according to various authors, the combination of these two serious pathologies occurs in 16-25 % of observations. For a long period, reconstructive-plastic surgery on BUS was a category of complex surgical interventions, required long-term intubation anesthesia, accompanied by a wide opening of the retroperitoneal space with careful allocation of the BUS area. Patients were in the hospital for a long time. Progress in the development of endoscopic equipment has contributed to the active introduction into clinical practice of minimally invasive techniques. Today, an increasing number of urologists are favoring different methods of laparoscopic plastics of BUS structures. But, both in the domestic and in the foreign literature, there are few works that would present advantages, complications, disadvantages of laparoscopic BUS plastic in combination with laparoscopic pyelolithotomy in patients with BUS complicated. This paper presents an analysis of our treatment of patients with BUS strictures in combination with urolithiasis.The objective: analysis and evaluation of the effectiveness of laparoscopic MCC plastics in combination with laparoscopic pyelolithotomy in patients with MCC obstruction complicated by SCC.Materials and methods. For the period from 2013 to 2019 41 patients with the above pathology were laparoscopically operated in the clinic of theInstitute ofUrology of the National Academy of Medical Sciences ofUkraine, including 25 men and 16 women. Their age ranged from 18 to 66 years. The length of the strictures – from 0.3 to1 cm. The size of the concretions varied from 0.5 to1.5 cm. One patient was found to be a coral stone of8.6 cm in size. There were no complications. The average length of stay in the hospital was 5.4 days.Results. In the distant postoperative period, there was no recurrence of BUS stricture and stone formation, stabilization or improvement of the secretory function of the kidney on the side of the plastic was noted. The effectiveness of our use of this method was 90.2 %, which allows us to consider it as the «gold» standard in the treatment of the above pathology.Conclusion. The use of laparoscopic plastics in combination with laparoscopic pyelolithotomy has made it possible to achieve good clinical results both in the immediate and long-term postoperative period. Timely surgery allowed us to achieve positive results in all patients with hydronephrotic transformation due to BUS stricture and complicated urolithiasis.

Pediatric Tracheostomy at a Tertiary Healthcare Institution: A Retrospective Study Focused on Outcomes.

The aim of this study was to retrospectively evaluate all pediatric tracheotomies that had been performed at Sanliurfa Training and Research Hospital From September 2016 to July 2019. A retrospective study was performed on pediatric patients who had undergone tracheostomy during the three-year study period. Patient data were reviewed for the following variables: age, gender, age at the time of tracheostomy, primary indication for tracheostomy, length of stay in intensive care unit before and after tracheostomy, complications, mortality and cause of death. The primary indication for tracheostomy was categorized into 4 separate groups: congenital disease, traumatic injury, prolonged intubation and other causes. The study group consisted of 138 children. Seventy-one (51.4%) of the children were male, 67 (48.6%) were female and the mean age of tracheostomy was 13.30 (0.03–192.27) months, and 44.2% were younger than 1 year when tracheotomy was performed. The median age at the time of tracheostomy was highest in children who underwent tracheostomy for traumatic injury. The indication for tracheostomy was prolonged intubation in 73.2% of the children. Complications were observed in 13 (9%) children; bleeding (69.2%) was the most common. Complications were most frequent in children who underwent tracheostomy for prolonged intubation. The overall mortality ratewas 30.4% with cardiac arrest being the most common cause. At our center, the most common indication for tracheostomy in children was long-term intubation, possibly due to our center being a tertiary healthcare institute. Bleeding was the most common complication, while cardiac arrest was the most common cause of death.