Tracheostomy: acute and long-term mortality and morbidity in very low birth weight premature infants.
Thirty-six very low birth weight premature infants (VLBW-PT) born at 24 to 32 weeks gestation and with birth weights 635 to 1,360 g who had tracheostomies performed for acquired subglottic stenosis or for prolonged mechanical ventilation were followed in relation to acute and long-term mortality and morbidity. Mortality due to the tracheostomy occurred in 4 patients (11%); mortality from all other causes was 25%. Death after hospital discharge was associated with the nonuse of prescribed cardiorespiratory monitors. Complications < 1 week postsurgery occurred in 31% of infants and complications > or = 1 week postsurgery occurred in 64% of infants. Fifty percent of infants required tracheostomy for > 2 years and/or extensive reconstructive surgery of the airway. Parents should be counselled that VLBW-PT infants with a tracheostomy may require extended medical and home care. An effective home care program requires parental training in tracheostomy care, the use of ancillary equipment, and infant cardiopulmonary resuscitation.
Schlessel
J S
JS
Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
Harper
R G
RG
Rappa
H
H
Kenigsberg
K
K
Khanna
S
S
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007829:Laryngostenosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology; D012121:Respiration, Artificial / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D014139:Tracheostomy / Q000401:mortality