Number Of Tracheotomies Research Articles

Trends in the use of tracheotomy in the pediatric patient: the Iowa experience.

The role of tracheotomy in airway management in children has been widely discussed. Improved medical care and technology have resulted in improved survival rates, and increased survival rates have been associated with changes in the indications for and the use of tracheotomy. The purpose of this review was to evaluate trends in the use of tracheotomy over a 15-year period. We reviewed the medical charts of patients who underwent tracheotomy from 1975 to 1989 and analyzed them over three 5-year time intervals: Block 1, 1975-79; Block 2, 1980-84; and Block 3, 1985-89. In the defined age group, 305 patients underwent tracheotomy during the study period. Records from 281 patients were analyzed; the remaining charts either were unavailable for review or did not contain adequate documentation of the tracheotomy. We observed an increase in the number of tracheotomies over time, especially in the younger population. Across blocks, median age decreased, duration of tracheotomy increased, and indications for tracheotomy changed. Mean age, duration of tracheotomy, and indications for tracheotomy changed over the 15-year period. Additionally, these parameters were strongly related.

Ludwig's angina: an analysis of 14 cases.

Ludwig's angina remains a potentially lethal disease entity as it causes rapidly progressive airway obstruction, although the current mortality rate is low. Early surgical intervention should be carried out in severe cases which show signs of fluctuation, abscess formation or other serious complications. We report our experience with 14 cases of Ludwig's angina, 12 of which (86%) were of dental origin. Only one case was complicated with Klebsiella pneumoniae septicemia which resolved upon treatment. There were no deaths. Surgical procedures including incision and drainage and tooth extraction were performed in 11 cases (78%). Antibiotics were administered to all patients. Most of them were treated with crystalline penicillin with or without an aminoglycoside. Only one patient received a tracheostomy in this series. The number of tracheostomies or intubations carried out was much lower than in previous reports. We suggest that an aggressive antimicrobial therapy, early surgical intervention and careful monitoring of the respiratory symptoms would reduce both the need for tracheostomy and the mortality rate.

Complications of tracheotomy.

TRACHEOTOMY (opening of the trachea) and tracheostomy (the creation of a more permanent opening in the trachea) are procedures which have become commonplace. It is the opinion of many that any physician should be able to quickly perform a tracheotomy at a moment's notice. This belief probably contributes to the high complication rates for this operation. It is our purpose here to discuss the complications of tracheotomy seen in 240 cases done over a two-year period in one hospital. The basic statistics of these procedures are outlined in Table 1 and explained below. As can be seen, general surgeons and otolaryngologists do approximately the same number of tracheotomies. This situation has shifted over the past year, however, so that while in 1962 and 1963, of the cases reviewed, 43 were done by otolaryngologists and 71 by general surgeons, in 1963 and 1964, 63 were done by otolaryngologists and 43 by