title: [Fatal complications in tracheotomized children].
abstract: BACKGROUND
  Tracheotomy in the pediatric patient has become a routine procedure since the late 19th century, when it was used in treating diphtheria. Although underlying diseases have changed, the child with an artificial airway still faces numerous risks. This study investigates fatal complications in 280 patients with tracheostomy who were seen in the Dr. von Haunersches Kinderspital for laryngo-tracheo-bronchoscopy.
  
  
  METHODS
  Data was acquired from patients' records of the Dr. von Haunersches Kinderspital and communications with other institutions.
  
  
  RESULTS
  Nineteen deaths were investigated. Three patients died of acute cannula obstruction although hospitalized in different institutions. Two patients who died at home may also have suffered cannula obstruction, although this could not be verified. The majority of patients succumbed to the underlying disease.
  
  
  CONCLUSIONS
  Permanent close supervision or monitoring at all times is critical to prevent cannular related deaths. Our results are compared with major series in other studies. In addition, we propose a booklet for the pediatric tracheotomy patient to document patient data and examination findings, e. g. type and size of cannula, duration of cannulation, laryngotracheometry, and complications. Its purpose will be to support communication between patients, parents, pediatricians, pediatric surgeons, and otolaryngologists. Furthermore, this booklet will help in evaluating risks, which may encounter pediatric tracheostomy patients, thereby enabling future studies.
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig Maximilians-Universität München.
authors.forename: N
authors.initials: N
authors.lastname: Kleinsasser
authors.forename: A
authors.initials: A
authors.lastname: Merkenschlager
authors.forename: C
authors.initials: C
authors.lastname: Schröter
authors.forename: C
authors.initials: C
authors.lastname: Mattick
authors.forename: T
authors.initials: T
authors.lastname: Nicolai
authors.forename: K
authors.initials: K
authors.lastname: Mantel
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000401:mortality; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D012307:Risk Factors; D014140:Tracheotomy / Q000295:instrumentation / Q000401:mortality*