Indications for tracheotomy in the pediatric intensive care unit population: a pilot study

Archives of Otolaryngology--head & Neck Surgery
Walter LeeJason Connor

Abstract

To define the indications for tracheotomy in patients requiring prolonged intubation (>1 week) in the pediatric intensive care unit (PICU). Retrospective chart review and follow-up telephone survey. A tertiary care center PICU. Tracheotomy or extubation. All patients older than 30 days in the PICU intubated for longer than 1 week between 1997 and 1999. During the study, 63 total admissions required intubation for longer than 1 week. A tracheotomy was necessary in 14% of admissions (n = 9). The mean length of intubation before the tracheotomy was 424 hours, whereas the mean length of intubation without the need for tracheotomy was 386 hours. Length of intubation, age, and number of intubations did not increase the probability of having a tracheotomy. Of those requiring a tracheotomy, 2 had tracheomalacia, 1 had subglottic edema, 1 had plastic bronchitis, 1 had Down syndrome with apnea resulting in right heart failure, 3 required long-term ventilation after cardiopulmonary collapse, and 1 had mitochondrial cytopathy. Of these 9 children, 7 were successfully decannulated, 1 patient died of underlying disease, and 1 patient remained cannulated secondary to the mitochondrial cytopathy. Twenty families of the patients who did not und...Continue Reading

Citations

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Related Concepts

Choking
Care of Intensive Care Unit Patient
Intubation, Intratracheal
Pilot Projects
Retrospective Studies
Tracheotomy Procedure
Pediatric Intensive Care Unit
Confidence Intervals
Survival Analysis
Benefit-Risk Assessment

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