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Pediatrics |

Tracheotomy Placement in Pediatrics: Indications, Timing, and Complications

Ricardo García-De Jesús*, MD; Anabel Puig-Ramos, PhD; Carlos Ocasio-Lopez, MD; Ingrid Mercedes, MD
Author and Funding Information

UPR-School of Medicine, Department of Pediatrics, Critical Care Section, San Juan, Puerto Rico


Chest. 2012;142(4_MeetingAbstracts):771A. doi:10.1378/chest.1390735
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Abstract

SESSION TYPE: Pediatric Critical Care Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: There are no recognized standardized timing intervals for tracheotomy placement in children. We evaluated the indications and clinical outcomes of children undergoing a tracheotomy placement admitted to the Pediatric Intensive Care Unit at the University Pediatric Hospital from 2006 to 2010.

METHODS: We conducted a retrospective medical records review of patients admitted to our Pediatric Critical Care Unit (PICU) at the University Pediatric Hospital from 2006 to 2010. We evaluated primary diagnosis, age, indication for tracheotomy placement, timing of the procedure, length of stay (LOS) and mortality related to the procedure.

RESULTS: During the study period there were a total of 63 tracheotomies performed. The most common indication identified was chronic respiratory failure, with primary diagnosis related to pulmonary diseases and neurological problems. Patients that required a tracheotomy placement were one year old or younger (44%) and had prolonged stay at the PICU. There was no mortality associated to the tracheotomy placement.

CONCLUSIONS: Early Identification of the risk factors for tracheotomy placement on patients with increased LOS (>15 days) and chronic respiratory problems or severe neurological compromise, may provide information about what is the better timing for tracheotomy placement in children admitted to the PICU.

CLINICAL IMPLICATIONS: Although there are advances in pediatric critical care that have led to increased survival rates in neonatal and pediatric patients, there is no recognized standardized timing intervals for tracheostomy placement in children. Knowing the risk factors of patients admitted to the PICU that required a tracheotomy placement will give us guidelines about the age and diagnosis to determine the perfect timing for the procedure to improve patients clinical course and reduce PICU lenght of stay.

DISCLOSURE: The following authors have nothing to disclose: Ricardo García-De Jesús, Anabel Puig-Ramos, Carlos Ocasio-Lopez, Ingrid Mercedes

No Product/Research Disclosure Information

UPR-School of Medicine, Department of Pediatrics, Critical Care Section, San Juan, Puerto Rico

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