Pediatric tracheostomy: A 10-year experience at a tertiary care teaching hospital in Eastern India

Abstract

BACKGROUND: Tracheostomy in pediatric patients is considered a surgery of significant morbidity and mortality. However, the airway management with tracheostomy in the pediatric age group has changed over time with respect to indication and outcome. OBJECTIVE: The objective of this study is to evaluate the indications and complications of pediatric tracheostomies. MATERIALS AND METHODS: This is a prospective study done on pediatric tracheostomies at a tertiary care teaching hospital. The study period was from September 2011 to October 2021. The data on age, gender, indications, and complications over 10 years were analyzed. In this study, pediatric tracheostomy was classified into prolonged intubation, obstruction in the upper airway, anomalies in the craniofacial region, neurological disorders, and vocal fold paralysis. If a child required ventilator assistance, they were placed in the prolonged intubation group. RESULTS: There were 162 pediatric tracheostomies performed during the study time. Of 162 children, 98 (60.49%) were male and 64 (39.50%) were female, with a male-to-female ratio of 1.5:1. Of 162 children, 112 (69.13%) underwent tracheostomy for prolonged ventilation and 50 (30.86%) underwent tracheostomy for upper airway obstruction. Intraoperative complications were seen in 9 (5.55%) cases of pediatric tracheostomy. There were 28 (17.28%) pediatric patients with a tracheostomy who presented with postoperative complications. CONCLUSION: Standardization of the pediatric tracheostomy, the timing of the procedure, and appropriate indications of pediatric tracheostomy are helpful to minimize morbidity and mortality in pediatric patients.

Keywords

• airway
• pediatric tracheostomy
• prolonged ventilation
• upper airway obstruction