Tracheotomy in the First Year of Life

Abstract

Much has been written concerning complications of pediatric tracheotomies, but few studies have reviewed the complication rates of tracheotomies performed in the first 12 months of life. We reviewed the records of 60 patients who underwent tracheotomy in the first year of life between 1976 and 1988. This study includes 30 full-term infants and 30 premature infants, 16 of whom were very low birth weight preterm infants (less than or equal to 32 weeks' gestation and less than 1,500 g birth weight). Overall complication rates were 3% intraoperative, 13% early postoperative, and 38% late postoperative. The early postoperative complication rate in preterm infants was nearly double that of full-term infants. The late postoperative complication rate of patients undergoing tracheotomy for airway obstruction was more than double that of patients requiring tracheotomy for pulmonary indications. Duration of tracheotomy, however, was felt to be the most important factor in the development of a late postoperative complication.

Should Granulomas Be Excised in Children With Long-term Tracheotomy?

“…Of the 33 unexcised granulomas, 16 (48%) resolved spontaneously; conversely, 18 (60%) of the 30 excised granulomas recurred. The median time to detection of recurrence was 3.4 months, with a range of 0.9 to 11.8 months (lower quartile, 1.5 months; upper quartile, 6.3 months).…”

Utility of routine postoperative chest radiography in pediatric tracheostomy

“…Complication rate was also associated with the degree of prematurity in this study. Gianoli et al [21] found that the early postoperative complication rate in preterm infants was nearly double that of full-term infants. Crysdale et al [22] found that the younger the patient at the time of the procedure, the greater the risk to the patient.…”

Acquired laryngeal stenosis in infants and children treated by laryngofissure and stenting

“…Two infants died under unclear circumstances after discharge to other hospitals, both had a stent connected to a tracheotomy cannula. In this respect it may be mentioned that the mortality rate of a tracheotomy in infants is reported to be O-5% [22]. Complications, including mortality, are related to younger age and longer duration of the tracheotomy [14,21,22].…”

“…In this respect it may be mentioned that the mortality rate of a tracheotomy in infants is reported to be O-5% [22]. Complications, including mortality, are related to younger age and longer duration of the tracheotomy [14,21,22]. The risks are probably further increased if a stent is connected to the cannula.…”