title: Pediatric tracheotomy: 3-year experience at a tertiary care center with 54 children.
abstract: The aim of this study was to evaluate the indications, complications and outcomes of pediatric tracheotomies at a tertiary care center. Data were obtained retrospectively from 54 patients who underwent tracheotomy from July 2007 to May 2010. Over the three-year period, 54 tracheotomies were performed. Thirty-two patients (59.3%) were male and 22 (40.7%) were female. The mean and median ages of the patients were 54 and 14 months (6 days-17 years), respectively. Twenty-six patients (48.1%) were under 1 year of age. The most common indication for tracheotomy was prolonged intubation (87%), followed by upper airway obstruction (13%). Five patients (9.2%) underwent tracheotomy under semiurgent settings. The overall complication rate was 29.6% (16/54). Early complications occurred in 7 patients (13%), including accidental decannulation in 2 patients, subcutaneous emphysema in 4 patients and hemorrhage in 1 patient. Late complications occurred in 9 patients (16.7%) (stomal granulation in 7 patients and stomal infection in 2 patients). Eight patients (14.8%) were decannulated successfully. No tracheotomy-related deaths occurred, with an overall mortality rate of 27.7% (15/54). Pediatric tracheotomy is a relatively safe procedure with a low incidence of procedure-related morbidities. The indication for the majority of the procedures was prolonged intubation (87%). The lower decannulation rate is related to the higher percentage of patients needing assisted ventilation and the relatively short follow-up period.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Atmaca
authors.forename: Cem
authors.initials: C
authors.lastname: Bayraktar
authors.forename: Nazik
authors.initials: N
authors.lastname: Aşilioğlu
authors.forename: Gökhan
authors.initials: G
authors.lastname: Kalkan
authors.forename: Zeki
authors.initials: Z
authors.lastname: Ozsoy
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D014140:Tracheotomy / Q000009:adverse effects / Q000706:statistics & numerical data