Abstract

Objective: Tracheostomy is one of the most frequently used surgical interventions in critically ill children in the intensive care unit. Pediatric tracheostomy; The small and flexible trachea is more difficult because of the limited surgical space and the risk of anesthesia. This study was conducted to analyze the indications, complications and outcomes of tracheostomy in a tertiary pediatric intensive care unit (PICU).

Methods: In this study, the data of patients who underwent tracheostomy in the PICU of a tertiary university hospital between January 2016 and December 2020 were evaluated retrospectively.

Results: A total of 43 pediatric patients underwent tracheostomy. The mean age of the patients was 52.2 months (minimum: 2, maximum: 192 months). Mean Risk of Pediatric Mortality: 20.6 (minimum: 8, maximum: 33), mean tracheostomy opening time: 24 days (minimum: 2, maximum: 52). The most common indication for tracheostomy was prolonged mechanical ventilation (MV) secondary to neuromuscular problems (34 cases, 79.1%), followed by upper airway obstruction (9 cases, 20.9%). While 35 (81.4%) of the patients were discharged, 8 (18.6%) died during intensive care follow-up.

Conclusion: Tracheostomy is a surgical intervention that can be safely applied in the PICU, especially in cases of prolonged MV. The opening time of the tracheostomy should be decided on a patient basis by the pediatric intensive care specialist.