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J Pediatr Surg. 2007 Jul;42(7):1251-4.

Tracheostomy--a 10-year experience from a UK pediatric surgical center.

Author information

1
Division of Child Health, The Royal Liverpool Children's Hospital, University of Liverpool, Eaton Road, Liverpool, L12 2AP, UK. hjcorbett@doctors.org.uk

Abstract

BACKGROUND/PURPOSE:

Tracheostomy in the pediatric population is associated with significant morbidity and mortality compared to adult practice. This study highlights evolving experience from a UK children's hospital.

PATIENTS AND METHODS:

All children undergoing tracheostomy between 1995 and 2004 were identified. Indications, complications, and outcomes were evaluated.

RESULTS:

Complete case records were reviewed for 112 children (age range, newborn-18 years). Indications included congenital birth defects--craniofacial disorders, esophageal atresia, laryngeal cleft, cystic hygroma, vascular malformations. Acquired upper airway pathology (15.5%) and malacia (12.1%) were additional criteria. Tracheostomy was also required for long-term ventilation in patients with neuromuscular disorders (12.1%) or ventilator dependency (26.7 %). Fifty-eight (50%) tracheostomies were created in infants <1 year. One hundred and nine were elective procedures with only 7 (6%) for emergency airway management. Morbidity included wound problems (14, 14.4%), tube displacement or obstruction (14, 14.4%), tracheocutaneous fistula (6, 6.2%), and pneumothorax (4, 4.1%). There were no acute hemorrhagic complications. Two children died after accidental tube displacement/obstruction.

CONCLUSION:

Tracheostomy at this UK center is largely undertaken as an elective procedure. Children less than 1 year form an increasing patient group. Complications may be minimized by meticulous surgical technique and ensuring a comprehensive tracheostomy care program.

PMID:
17618889
DOI:
10.1016/j.jpedsurg.2007.02.017
[Indexed for MEDLINE]

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