Peadiatric Tracheostomy: An experience in Tertiatry Care Hospital

Abstract

ABSTRACT

Introduction: Tracheostomy is the surgical procedure originally described in 1^st century BC. It is the life saving procedure when performed with appropriate indications and surgical technique. Tracheostomy in the pediatric population is a particularly hazardous procedure.

Study Design: Retrospective chart review

Duration & place of study: This study was conducted at the Peoples University of Medical & Health Sciences Hospital Nawabshah between 2004 to 2008.

Materials and methods: Retrospective review of pediatric tracheostomy done in emergency or elective procedure under general anesthesia or local anesthesia was under taken. Name, age, indications, time of decanulation and follow up were evaluated. 

Results: 31 Pediatric patients had tracheostomies within study period. There were 19 males and 12 females. Age range was 2 months to 10 years. The most common indication of tracheostomy was upper respiratory tract obstruction due to traumatic causes (54.83%). 83.87% tracheostomies were done in emergency while 16.12% as elective procedure under general anesthesia or local anesthesia. Complications were encountered in 32.25%of patients. Most frequent complication was granulation tissue formation in the area around stoma (30%). Complication rate was high in patients below 2 years of age (63%) and in patients having emergency tracheostomy (73.9%). Decanulation was successfully done in all alive patients (87%). Overall mortality rate was 12.9%. There was no tracheostomy related mortality.

Conclusion: The indications for pediatric tracheostomy are changed from airway obstruction due to infection to trauma. Complication rate of tracheostomy is higher in younger age groups. Mortality and outcome of these patients depends primarily on underlying medical condition of the patient, otherwise pediatric tracheostomy is safe when performed in tertiary hospital settings.