Tracheostomy trends in paediatric intensive care

Arch Dis Child. 2021 Jul;106(7):712-714. doi: 10.1136/archdischild-2020-319396. Epub 2020 Oct 6.

Abstract

Paediatric tracheostomy is most commonly performed in children on the paediatric intensive care unit (PICU) to facilitate long-term ventilation. We sought to identify trends in UK tracheostomy practice in PICUs. Data were analysed from 250 261 admissions, including 4409 children tracheostomised between 2003 and 2017. The incidence of tracheostomy in 2017 was approximately half that in 2003 (incidence rate ratio=0.48, 95% CI 0.40 to 0.57). The percentage of patients tracheostomised during a PICU admission, as a proportion of all admissions, was 2.44% (n=319) in 2003 and reduced to 0.97% (n=180) in 2017. Nevertheless, we identified great variability in practice between different PICUs with tracheostomy rates between 0.0% and 4.0% of all admissions. Risk-adjusted PICU mortality was comparable between tracheostomised children and all admissions to PICU.

Keywords: ent; intensive care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Pediatric / statistics & numerical data*
  • Intensive Care Units, Pediatric / trends
  • Male
  • Noninvasive Ventilation / methods
  • Noninvasive Ventilation / mortality
  • Noninvasive Ventilation / statistics & numerical data
  • Respiration, Artificial / methods
  • Respiration, Artificial / mortality
  • Respiration, Artificial / statistics & numerical data
  • Tracheostomy / mortality
  • Tracheostomy / standards
  • Tracheostomy / statistics & numerical data*
  • Tracheostomy / trends
  • United Kingdom / epidemiology