Surgical tracheostomy in children with malignancy receiving intensive chemotherapy: A case series and review of literature

Manna, Soumendu S.; Malik, Rubina; Douthwaite, A. H.; Vaidya, Sucheta

doi:10.1002/pbc.28105

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…The most reported complications include infection and granuloma formation with rare serious events. Two reports of tracheostomy in immunocompromised patients include a case report of neutropenic adults with no increase in early complication rates (13) and a pediatric cohort with minor complications reported in 50% of patients (14). The overall complication rate in this study was 34.7%.…”

Section: Discussionmentioning

confidence: 99%

Outcomes for Pediatric Oncology and Hematopoietic Stem Cell Transplantation Patients Who Undergo Tracheostomy Placement: A Pediatric Health Information System Database Cohort Study, 2009–2020

Murphy Salem,

Perez,

Staffa

et al. 2024

Pediatric Critical Care Medicine

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Objectives: To describe the epidemiology, surgical complications, and long-term outcomes after tracheostomy in pediatric oncology and/or hematopoietic stem cell transplantation (HSCT) patients in U.S. Children’s Hospitals. Design: Retrospective cohort from the Pediatric Health information System (PHIS) database, 2009–2020. Setting: The PHIS dataset incorporates data from 48 pediatric hospitals in the Children’s Hospital Association. Patients: Patients 0–21 years old with an oncologic diagnosis and/or underwent HSCT, received a tracheostomy, and were discharged from hospital between January 1, 2009, and December 31, 2020. Interventions: None. Measurements and Main Results: There were 1061 patients included in the dataset, and 217 (20.5%) had undergone HSCT. The annual prevalence in tracheostomy usage did not change over the study period. The majority of patients (62.2%) underwent tracheostomy early (< 30 d) in the admission and those who underwent the procedure later (> 90 d) had a significant increase in mortality (52.6% vs. 17.6%; p < 0.001) and mechanical ventilation (MV) at discharge (51.9% vs. 24.5%; p < 0.001) compared with the early tracheostomy patients. Complications reported included tracheostomy site bleeding (< 1%) and infection (24%). The overall rate of MV at discharge was 32.6% and significantly associated with chronic lung (adjusted odds ratio [OR], 1.54; 95% CI, 1.03–2.32) and acute lung disease (OR, 2.18; 95% CI, 1.19–3.98). The overall rate of mortality was 19.6% within the cohort and significantly associated with HSCT (OR, 5.45; 95% CI, 3.88–7.70), diagnosis of sepsis (OR, 2.09; 95% CI, 1.28–3.41), and requirement for renal replacement therapy (OR, 2.76; 95% CI, 1.58–4,83). Conclusions: This study demonstrated a static prevalence of tracheostomy placement in the cohort population relative to the increasing trends in other reported groups. Regardless of underlying diagnosis, the study patients incurred substantial morbidity and mortality. However, tracheostomy specific complication rates were comparable with that of the general pediatric population and were not associated with increased odds of mortality within this population.

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Section: Discussionmentioning

confidence: 99%

Outcomes for Pediatric Oncology and Hematopoietic Stem Cell Transplantation Patients Who Undergo Tracheostomy Placement: A Pediatric Health Information System Database Cohort Study, 2009–2020

Murphy Salem,

Perez,

Staffa

et al. 2024

Pediatric Critical Care Medicine

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“…Although surgical tracheostomy in the presence of severe immunosuppression and thrombocytopenia is not a contraindication, it may be associated with increased risk of surgical complications. Studies regarding this topic are scarce, especially in the pediatric population and do not support a recommendation [13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

Life-threatening oral mucositis following chemotherapy in a pediatric patient

Tsuboi

Sakamoto

et al. 2021

Preprint

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“…Although surgical tracheostomy in the presence of severe immunosuppression and thrombocytopenia is not a contraindication, it may be associated with increased risk of surgical complications. Studies regarding this topic are scarce, especially in the pediatric population, and do not support a recommendation 13‐15 …”

Section: Discussionmentioning

confidence: 99%