Tracheostomy in children.


Autoria(s): Simma B.; Spehler D.; Burger R.; Uehlinger J.; Ghelfi D.; Dangel P.; Hof E.; Fanconi S.
Data(s)

1994

Resumo

We reviewed the records of 108 patients who had a tracheostomy performed over a 10-year period from July 1979 to April 1989. Median age at tracheostomy was 6 months (1 week-15 years). Indications for surgery were acquired subglottic stenosis (31.4%), bilateral vocal cord paralysis (22.2%), congenital airway malformations (22.2%) and tumours (11.1%). No epiglottis and no emergency situation had to be managed by tracheostomy. Operation was uneventful in all, but 8 patients (7.4%) developed a pneumothorax in the postoperative period. Twenty-one (19.5%) had severe complications during the cannulation period (tube obstruction in 11 patients with cardiorespiratory arrest in 4; dislocation of the tube in 6 patients). Fifteen patients (13.8%) had severe complications after decannulation (2 had a cardiorespiratory arrest); all 15 had to be recannulated. At the end of the study period 85 patients (78.7%) were successfully decannulated with a median period of tracheostomy of 486 days (8 days-6.6 years). The median hospital stay was 159 days (13 days-2.7 years). All patients could be discharged. Eight patients (7.4%) died but no death was related to tracheostomy. In summary the mortality rate is lower than reported in previous reviews and tracheostomy is a safe operation even in small children but cannula-related complications may lead to life-threatening events. The management of tracheostomized small children and infants in a highly staffed and monitored intensive care unit has allowed better handling of complications and has resulted in a reduction in cannula-related deaths.

Identificador

http://serval.unil.ch/?id=serval:BIB_DC74CD99E0F8

isbn:0340-6199

pmid:8194567

isiid:A1994NC57300018

Idioma(s)

en

Fonte

European journal of pediatrics, vol. 153, no. 4, pp. 291-6

Palavras-Chave #Adolescent; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Intensive Care Units, Pediatric; Retrospective Studies; Tracheostomy
Tipo

info:eu-repo/semantics/review

article