Is tracheotomy decannulation possible in oxygen-dependent children?
OBJECTIVE
The goal was to determine whether decannulation can be safely achieved in children with persistent oxygen requirements.


METHODS
The study was a prospective evaluation of 12 oxygen-dependent children at a tertiary care academic children's medical center.


METHODS
Twelve tracheotomy-dependent children with persistent oxygen requirements were evaluated for decannulation. Patients requiring more than 35% FiO(2) were not considered. Direct laryngoscopy and bronchoscopy were performed in all patients. Two required single-stage laryngotracheoplasty to correct subglottic stenosis, 1 required tracheal resection, and 7 required removal of suprastomal granulation tissue. Oxygen was administered after decannulation through a nasal cannula.


RESULTS
Decannulation was successful in 92% (11 of 12) of patients. At final follow-up, oxygen requirements decreased in 58% of patients after decannulation.


CONCLUSIONS
Decannulation can be successful in children who remain oxygen dependent; conversion to a more physiologic airway may be an adjunct to reducing or eliminating their oxygen demand.
Picerno
N A
NA
Divisions of Otolaryngology and Pediatric Pulmonology and the School of Medicine, Medical College of Georgia, Augusta, USA.
Bent
J P
JP
Hammond
J
J
Pennington
W
W
Guill
M F
MF
Hudson
V L
VL
Deane
D A
DA
D001997:Bronchopulmonary Dysplasia / Q000601:surgery*; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006097:Granulation Tissue / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial; D014140:Tracheotomy