title: Current trends in paediatric tracheostomies.
abstract: OBJECTIVE
  In the 1970s, the most common indication for tracheostomy in children was acute inflammatory airway obstruction. Modern neonatal intensive care units have turned long-term intubation into an alternative to tracheostomy. Long-term intubation itself has become the most important indication for tracheostomy combined with subglottic stenosis.
  
  
  METHODS
  Retrospective analysis in a tertiary referral center. A total of 38 patients who underwent tracheostomy for respiratory failure and upper airway obstruction from 1 November 1998 to 30 November 2004.
  
  
  RESULTS
  Total complication rate was 42.1%. In children under 1 year of age the complication rate was 47.4%, in children over 1 year the complication rate was 26.3%. Decannulation was attempted in 12 patients with a cannulation time of 22 months.
  
  
  CONCLUSIONS
  Long-term intubation and its sequelae have now become one of the most important indication for tracheostomy. The change of indication has also entailed a decrease of the average age of children who require tracheostomy. A longer period before decannulation and a lower average age have changed the complication rate of tracheostomy in paediatric patients.
authors.affiliation: Institute of Otolaryngology, Sacro Cuore Catholic University, Rome, Italy. claudioparrilla@yahoo.com
authors.forename: Claudio
authors.initials: C
authors.lastname: Parrilla
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scarano
authors.forename: Maria Lavinia
authors.initials: ML
authors.lastname: Guidi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Galli
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paludetti
mesh_terms: D000208:Acute Disease; D000402:Airway Obstruction / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D010372:Pediatrics / Q000706:statistics & numerical data / Q000639:trends*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014139:Tracheostomy / Q000706:statistics & numerical data / Q000639:trends*