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Laryngoscope. 2014 Aug;124(8):1952-8. doi: 10.1002/lary.24596. Epub 2014 Feb 20.

Pediatric tracheotomy: indications and decannulation outcomes.

Author information

1
Department of Otolaryngology, UC Davis School of Medicine, Sacramento, California, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

The objective of this study was to determine if there are differences in decannulation rates and duration of cannulation between pediatric patients undergoing tracheotomy for different indications.

STUDY DESIGN:

Retrospective chart review.

METHODS:

Medical records for pediatric patients (age 0-18 years) undergoing tracheotomy between January 1, 2003, and May 31, 2012, were retrospectively reviewed. Patients were assigned an indication for tracheotomy from five categories: neurological, cardiopulmonary, upper airway obstruction, craniofacial anomalies, and maxillofacial/laryngotracheal trauma.

RESULTS:

Initial chart review identified 124 patients, 113 for whom complete data was available. Of these patients, the indications for tracheotomy were cardiopulmonary disease in 24 (21.2%), craniofacial anomalies in 12 (10.6%), neurological impairment in 44 (38.9%), traumatic injury in 11 (9.7%), and upper airway obstruction in 22 (19.5%). The time to decannulation was shorter for trauma patients compared to cardiopulmonary (P = 0.044) and neurological patients (P = 0.001). A total of 32 (31.9%) patients were decannulated during the study period, with a higher rate in trauma patients (72.7%) and a lower rate in those with upper airway obstruction (36.4%) than would be expected under homogeneity. Of the 32 patients who were decannulated, 11 (30.6%) were decannulated during the same hospitalization in which the tracheotomy was performed.

CONCLUSION:

This study demonstrates a difference in overall decannulation rates and a shorter time to decannulation in children undergoing tracheotomy for maxillofacial and laryngotracheal trauma compared to cardiopulmonary and neurological indications.

KEYWORDS:

Pediatric tracheotomy; decannulation; tracheostomy; upper airway obstruction

PMID:
24430892
PMCID:
PMC4099419
DOI:
10.1002/lary.24596
[Indexed for MEDLINE]
Free PMC Article

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