Causes and Outcome of Tracheostomy in Children

Jungmin Suh; Jung Hyun Lee; Man-Ki Chung; Han-Sin Jeong; Young-Ik Son; Kangmo Ahn; Sang-Il Lee

doi:10.7581/pard.2012.22.2.188

Journal List > Pediatr Allergy Respir Dis > v.22(2) > 1033172

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Suh, Lee, Chung, Jeong, Son, Ahn, and Lee: Causes and Outcome of Tracheostomy in Children

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(2): 188-196.

Published online: 30 June 2012

DOI: https://doi.org/10.7581/pard.2012.22.2.188

Causes and Outcome of Tracheostomy in Children

Jungmin Suh, MD¹, Jung Hyun Lee, MD², Man-Ki Chung, MD³, Han-Sin Jeong, MD, PhD³, Young-Ik Son, MD, PhD³, Kangmo Ahn, MD, PhD⁴, Sang-Il Lee, MD, PhD⁴

¹Department of Pediatrics, Sahmyook Medical Center, Seoul, Korea.

²Department of Pediatrics, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea.

³Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

⁴Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author (kmaped@skku.edu)

Received 18 February 2012 Revised 8 March 2012 Accepted 26 March 2012

Abstract

Purpose

Tracheostomy is used to aid airway management in perdiatric respiratory care. This study was designed to review causes and outcomes of pediatric tracheostomy.

Methods

We performed a retrospective chart review of 153 patients, less than 18 years of age, who underwent tracheostomy between January 1995 and July 2010. Age at tracheostomy, indications, durations, complications and mortality were evaluated.

Results

Subglottic stenosis (19%) was the most common indication for tracheostomy. The median age at tracheostomy was 1.3 years (range, 22 days to 17.8 years). Seventy-three (47.7%) tracheostomies were performed in children under 1 year of age. Respiratory diseases were significantly more prevalent in patients under 1 year of age, while neuromuscular disease were more frequently found in patients older than 1 year (P=0.013). Stoma or tracheal granuloma formation (36.6%) was the most common complication of pediatric tracheostomy. Decannulation was accomplished in 61 (39.9%) patients with median cannulation time of 141 days (range, 1 to 2,529 days). Overall mortality rate was 10.5% (n=16), but only one patient (0.7%) died from tracheostomy-related complications.

Conclusion

Respiratory diseases, such as subglottic stenosis and neuromuscular disease, are the main cause of pediatric tracheostomy. Although complications, like stoma or tracheal granuloma formation occur, tracheostomy in children is a safe way to aid airway management.

Keywords: Tracheostomy, Children, Airway management, Complications

Figures and Tables

Fig. 1

Age at time of tracheostomy.

Fig. 2

Age at time tracheostomy younger than 1 year.

Table 1

Causes of Tracheostomy in Children

Values are presented as number (%).

^*Obstructive sleep apnea, acute epiglottitis, postpneumonectomy syndrome, subglottic hemangioma, airway trauma.

^†Brain involvement of Sjogren's syndrome, neuronal ceroid lipofuscinosis, non traumatic brain hemorrhage, cerebral infarction, Guillian-barre syndrome, congenital myotonic dysplasia, congenital nonprogressive ataxia, skelectal dysplasia, non-specific neuromuscular disease.

Table 2

Clinical Course of Tracheostomy in Children

Values are presented as number (%) or median (range).

Table 3

Clinical Course of Tracheostomy in Children according to Causes

^*Values are presented as median (range).

Table 4

Complication of Tracheostomy in Children

^*Pressure sore of the skin and soft tissue under tracheostomy device.

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