A Clinical Study of Pediatric Tracheotomy

BACKGROUND AND OBJECTIVES: As indications for tracheotomy have evolved over the decades, the trends in the pediatric tracheotomy also have changed. The purpose of this study is to review the clinical courses and outcomes in the current pediatric tracheotomy. MATERIALS AND METHOD: A retrospective study was performed on 42 pediatric patients who underwent tracheotomies at Ajou University Hospital from June, 1994 to May, 2004. Charts were reviewed with respect to indications for tracheotomy, underlying diseases, success rate in decannulation and length of support time until decannulation, complication and mortality rate. RESULTS: There were 34 (81.0%) male patients and 8 (19.0%) female patients. Ventilatory support for neurological impairment (47.6%) was the leading indication for tracheotomy, followed by upper airway obstruction (19.0%), prolonged intubation due to respiratory failure (16.7%), cervical trauma (7.1%), craniofacial abnormalities (4.8%) and vocal cord palsy (4.8%). Convulsive disorder (19.0%) and congenital neurological malformation (14.3%) were the most common underlying diseases. Decannulation was accomplished in 70.0% of children with an average of 254.5 days with tracheotomy. The length of support time until decannulation was significantly greater in the neurological impairment group than in the other group. Complications occurred in 19.0% without tracheotomy-related death. CONCLUSION: Tracheotomy is relatively safe in the pediatric population as conservative therapy and its outcomes are thought to be usually related to the underlying disease and age