[Analysis of tracheostomies in a pediatric intensive care unit during the period 2003-2013]

Abstract

Introduction: Tracheotomy in pediatric patients is a rare procedure. In this pediatric series, perioperative complications, mortality related to surgical procedure and overall mortality are analyzed.

Patients and methods: This is a retrospective study conducted from January 2003 to December 2013. Data were retrieved from patients who were tracheotomized and admitted to our PICU in the postoperative period.

Results: Data were collected from 25 tracheotomized patients admitted during the study period. The mean age was 3.3 months (median 14 months, range 1-144 months), and PICU length of stay was 53 days (median 37 days, range 1-338 days). Most patients (68%) had comorbidities before their admission, with a higher prevalene of craniofacial anomalies/polymalformative syndromes (32%) and prematurity related disorders (12%) being obserevd. The most common etiologies related to the procedure were congenital airway obstruction (16%) and several types of spinal cord injury (16%), followed by tracheobronchomalacia (12%) and subglottic stenosis (12%). Some kind of complication was detected in 40% of patients, with accidental decannulation being the most frequent. Accidental or unexpected decannulation was present in a percentage as high as 20% of our patients, mainly in the first 24 hours after surgery. One of the patients died as a result of this.

Conclusions: The postoperative course of a tracheotomy is associated with a high rate of complications, some of them related to life-threatening events.

Keywords: Complicaciones postoperatorias; Pediatric Intensive Care Units; Pediatrics; Pediatría; Postoperative complications; Tracheotomy; Traqueotomía; Unidades de Cuidado Intensivo Pediátrico.