Indications, risk of lower airway infection, and complications to pediatric tracheotomy: report from a tertiary referral center

TY - JOUR

T1 - Indications, risk of lower airway infection, and complications to pediatric tracheotomy

T2 - report from a tertiary referral center

AU - Grønhøj, Christian

AU - Charabi, Birgitte

AU - Buchwald, Christian von

AU - Hjuler, Thomas

PY - 2017/8/3

Y1 - 2017/8/3

N2 - Background: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. Methods: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008–2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI. Results: At a median age of 8 years (range: 4 months to 17 years), a total of 69 tracheotomies were performed. Neuromuscular disease (n = 21) was the most common cause for tracheotomy. The postoperative complication rate was 22%; early complications (<30 days) occurred in four patients, and nine patients encountered late complications such as wound granulation and tracheocutaneous fistula. Children without LAI prior to tracheotomy were at increased risk of LAI from the initial 30-days following surgery (OR: 2.91, 95% CI: 1.17–7.21; p =.02). Fifty-three percent (10/19) of all LAIs following tracheotomy were caused by Staphylococcus aureus (p <.01). Conclusions: Pediatric tracheotomy was associated with considerable rates of minor early and late complications and high risk of short-term LAI. The main cause leading to tracheotomy was neuromuscular disease.

AB - Background: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. Methods: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008–2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI. Results: At a median age of 8 years (range: 4 months to 17 years), a total of 69 tracheotomies were performed. Neuromuscular disease (n = 21) was the most common cause for tracheotomy. The postoperative complication rate was 22%; early complications (<30 days) occurred in four patients, and nine patients encountered late complications such as wound granulation and tracheocutaneous fistula. Children without LAI prior to tracheotomy were at increased risk of LAI from the initial 30-days following surgery (OR: 2.91, 95% CI: 1.17–7.21; p =.02). Fifty-three percent (10/19) of all LAIs following tracheotomy were caused by Staphylococcus aureus (p <.01). Conclusions: Pediatric tracheotomy was associated with considerable rates of minor early and late complications and high risk of short-term LAI. The main cause leading to tracheotomy was neuromuscular disease.

KW - Adolescent

KW - Child

KW - Child, Preschool

KW - Cutaneous Fistula/epidemiology

KW - Denmark/epidemiology

KW - Female

KW - Granulation Tissue

KW - Humans

KW - Infant

KW - Male

KW - Neuromuscular Diseases/therapy

KW - Postoperative Complications

KW - Respiratory Tract Infections/epidemiology

KW - Retrospective Studies

KW - Staphylococcal Infections/epidemiology

KW - Tertiary Care Centers

KW - Tracheotomy/adverse effects

U2 - 10.1080/00016489.2017.1295469

DO - 10.1080/00016489.2017.1295469

M3 - Journal article

C2 - 28338364

SN - 0001-6489

VL - 137

SP - 868

EP - 871

JO - Acta Oto-Laryngologica

JF - Acta Oto-Laryngologica

IS - 8

ER -