Abstract

Objective: Tracheostomy has become a frequent surgical procedure for pediatric intensivists asit reduces the patient’s sedation needs and the length of the Pediatric Intensive Care Unit (PICU) stay and also improves the efficiency of pulmonary secretion clearance. Despite previous studies on tracheostomy indications, timing and complications, there is limited information on extubation success and decanulation. In this study, we aimed to present the decanulation and weaning from mechanical ventilator results after tracheostomy.

Material and Methods: This study was carried out retrospectively from the records of patients who underwent tracheostomy between January 2010 and August 2016 at the Erciyes University Medical Faculty Pediatric Intensive Care Unit.

Results: A total of 107 patients were included in this study. There were 55 (51.4%) males and 52 (48.6%) females. The median age of the patients was 23 months and the duration of mechanical ventilation before tracheostomy was 23 days. The most common indication was long-term ventilation (81.3%), followed by airway abstruction (14%), and pulmonary toilet (4.7%). Sixty five were weaned from the mechanical ventilator and 28% of the patients were decannulated. The ET group PICU stay was 23 days, and the LT group PICU stay was 52 days (p<0.01). There was no significant difference in mortality between the two groups (p=0.786).

Conclusion: Tracheostomy is a good choice in terms of alleviating the chronic patient burden in our country where there is limited pediatric intensive care capacity

Keywords: Child, Decanulation, Mechanical ventilator, Tracheostomy

References

  1. Mahafza T, Batarseh S, Bsoul N, Massad E, Qudaisat I, Al-Layla AE. Early vs. late tracheostomy for the ICU patients: Experience in a referral hospital. Saudi J Anaesth 2012;6:152-4.
  2. Hofer CK, Ganter M, Tucci M, Klaghofer R, Zollinger A. How reliable is length based determination of body weight and tracheal tube size in the paediatric age group? Br J Anaesth 2002;88:283-5.
  3. Tolunay İ, Yıldızdaş RD, Horoz ÖÖ, Sürmelioğlu Ö, Ekinci F, Petmezci E ve ark. Çocuk yoğun bakım ünitemizde trakeostomi açılan hastalarımızın değerlendirilmesi. CAYD 2015;2:61-4.
  4. Dursun O, Ozel D. Early and long-term outcome after tracheostomy in children. Pediatr Int 2011;53:202-06.
  5. Cai SQ, Hu JW, Liu D, Bai XJ, Xie J, Chen JJ, et al. The influence of tracheostomy timing on outcomes in trauma patients: A meta- analysis. Injury 2017;48:866-73.
  6. Brook AD, Sherman G, Malen J, Kollef MH. Early versus late tracheostomy in patients who require prolonged mechanical ventilation. Am J Crit Care 2000;9:352-59.
  7. Lee JH, Koo CH, Lee SY, Kim EH, Song IK, Kim HS, et al. Effect of early vs. late tracheostomy on clinical outcomes in critically ill pediatric patients. Acta Anaesthesiol Scand 2016;60:1281-8.
  8. Zia S, Arshad M, Nazir Z, Awan S. Pediatric tracheostomy: Complications and role of home care in a developing country. Pediatr Surg Int 2010;26:269-73.
  9. Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in pediatric tracheostomies. Laryngoscope 2001;111:1925-28.
  10. Parrilla C, Scarano E, Guidi ML, Galli J, Paludetti G. Current trends in paediatric tracheostomies. Int J Pediatr Otorhinolaryngol 2007;71:1563-7.
  11. Lee W, Koltai P, Harrison AM, Appachi E, Bourdakos D, Davis S, et al. Indications for tracheotomy in the pediatric intensive care unit population: A pilot study. Arch Otolaryngol Head Neck Surg 2002;128:1249-52.

Copyright and license

How to cite

1.
Dursun A, Tekerek NÜ, Akyıldız B. The Evaluation of Tracheotomy Cases in the Pediatric Intensive Care Unit: The Results of Decanulation and Weaning from Mechanical Ventilator. Turk J Pediatr Dis [Internet]. 2018 Aug. 1 [cited 2025 May 25];12(2):74-8. Available from: https://turkjpediatrdis.org/article/view/518