Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
To provide an overview of pediatric tracheostomy, focusing on indications, surgical techniques and complications. The indications for pediatric tracheostomy are changing. Today the most common indication is assisted ventilation. Tracheostomy complications are more likely in children than in adult and more common in children under two years particularly preterm infant.
The general indications for tracheostomy are as follows:
• Relieve upper airway obstruction.
• Prevent complications of prolonged intubation
• Reduce anatomical dead space
• Allow suction toilet of the trachea
OBJECTIVE:
To evaluate the indications and complications of tracheostomies performed in children.
PATIENTS AND METHOD:
This is prospective study of 20 patients for whom tracheostomy was done during a period of two years (from October 2011 to October 2013).
Demographic data and details of the surgical work and the follow up notes were collected.
Descriptive, and analytic statistics were applied to the set of data using the Microsoft excel 2010 computer system.
RESULTS:
Total of twenty patients were included in the study. The age range was 2months – 12 years there were 14 males and 6 females.
Fifty percent of the patients were 5 year old or younger.
Sixty five percent of the operations were performed as elective procedures, and 35% as emergency.
The peak incidence of tracheostomy was at 5 years (25%).
The most common indication was the need for assisted ventilation 60%.
The most common underlying cause behind tracheostomy was the neurological impairment whether chronic or traumatic (n=13; 65%), followed by airway trauma.
No intraoperative complications were reported, and the postoperative complication rate was 25%.
Tracheostomy tube (PORTEX blue line) obstruction was the most common encountered complication.
Fourteen patients were decannulated (70%) with mean duration prior to decannulation 19.7± 18.95 days.
There were no tracheostomy related mortalities.
CONCLUSION:
A ssisted ventilation is the most common indication for traceostomy in pediatric age group. Tracheostomy in children is a safe procedure with negligible intraoperative complications.