Pediatric tracheostomy: indications and outcomes from Indian tertiary care centre

Abstract

Background: Pediatric tracheostomy has always been more challenging due to varoius factors. The present study was carried out to assess various indications, complications and outcomes of pediatric tracheostomy. Methods: It was a prospective observational study in a tertiary care teaching hospital conducted over four years. Observations were recorded in form of indication, any surgical challenge, complications and postoperative follow up. Results: Total 29 tracheostomies done in patients less than 12 years were included in the study. Majority of cases were infants (86%). Majority of patients were tracheostomised for lower respiratory infective cause who required prolonged ventilatory support (35%) followed by neurological cause (31%), obstructive cause (24%) and head injury (10%). Two most common complications were tube blockage (10%) and peristomal granulations (10%) which were suitably addressed. There has been no tracheostomy related mortality in the present study. All the patients who were considered for decannulation underwent check endoscopy. Out of 29 patients, 6 patients were lost in follow up. Out of the remaining, decannulation was successful in 16 patients (76%). Conclusions: Pediatric tracheostomies with better care facilities and trained team, there are fewer complications and higher rates of decannulation. The average age of children undergoing tracheostomy has come down. There is changing trends in the indications of tracheostomies from infective causes to causes requiring prolonged ventilation. The complication rates have declined with proper decannulation protocol.