Original ArticleChanges in pediatric tracheostomy 1982–2011: a Canadian tertiary children's hospital review
Section snippets
Methods
A retrospective chart review of all tracheostomy cases performed at BCCH from 1982 to 2011 with follow-up review until 2011 was conducted. Ethical approval was obtained from the University of British Columbia/Children's and Women's Health Centre of British Columbia Research Ethics Board. All tracheostomy procedures over the 30 year period were done by 11 surgeons with varying levels of experience using commonly practiced tracheostomy techniques. The majority of tracheal incisions were made
Results
Two hundred and sixty seven tracheostomies were performed at BCCH from 1982 to 2011. This review includes 251 procedures performed on 231 patients (154 male, 97 female), 16 patients were excluded owing to inability to access records. In 16 of the 251 cases (6%) reviewed, complete information could not be found; however, the information that was available from these patient charts was included in analysis and n values were adjusted to reflect missing patients. For the entire cohort, average age
Discussion
At BCCH frequency of tracheostomy has declined over the 1990's and into the 2000's. In the most recent 10 years of this review there has been a plateau and slight increase in the number of procedures performed. This pattern is generally consistent with the current literature, although the plateau has been reported to start earlier [10]. Some spikes in frequency may be explained by corresponding increases in premature infants for that year, however not all spikes show this corresponding increase.
Conclusions
At BCCH patients with a tracheostomy have changed in relation to frequency, indications, complications and decannulation rates over the last 30 years. This review presents an increase in complications over time and decrease in percent decannulated, as indicated by the changes from the first ten year time period to the second. These changes may be the result of increased length of time in situ and complexity of indication for the average tracheostomy patient. Overall, low rates of complication
Acknowledgments
Rachelle Dar Santos- for administrative assistance.
Current and former members of the Division of Pediatric Otolaryngology.
All surgeons who have performed a tracheostomy at BCCH.
References (31)
- et al.
Pediatric tracheotomy: 17 year review
Int J Pediatr Otorhinolaryngol
(2007) - et al.
Pediatric tracheotomy: are the indications changing?
Int J Pediatr Otorhinolaryngol
(2013) - et al.
Tracheostomy—a 10-year experience from a UK pediatric surgical center
J Pediatr Surg
(2007) - et al.
Pediatric tracheotomy: a 30-year experience
J Pediatr Surg
(2013) - et al.
Tracheostomy in children- the Red Cross War Memorial Children's Hospital experience 1980–1985
Int J Pediatr Otorhinolaryngol
(1989) - et al.
Pediatric tracheotomies: a 37-year experience in 282 children
Int J Pediatr Otorhinolaryngol
(2009) - et al.
Tracheotomy in children: evolution in indications
Int J Pediatr Otorhinolaryngol
(2006) - et al.
Pediatric tracheotomies in an Asian population: the Singapore experience
Otolaryngol Head Neck Surg
(2005) - et al.
Outcome in pediatric tracheotomy
Am J Otolaryngol
(2003) - et al.
Indications, complications, and surgical techniques for pediatric tracheostomies- an update
J Pediatr Surg
(2002)
Current trends in pediatric tracheotomy
Int J Pediatr Otorhinolaryngol
The changing indications for paediatric tracheostomy
Int J Pediatr Otorhinolaryngol
A twenty year (1971–1990) review of tracheostomies in a major paediatric hospital
Int J Pediatr Otorhinolaryngol
A single-center 6-year with two types of pediatric tracheostomy
Int J Pediatr Otorhinolaryngol
Pediatric tracheotomy: 3-year experience at a tertiary care center with 54 children
Turk J Pediatr
Cited by (67)
Republication of: Tracheostomized children tracheal colonization and antibiotic resistance profile - A STROBE analysis
2023, Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-FacialeTracheostomized children tracheal colonization and antibiotic resistance profile – A STROBE analysis
2023, European Annals of Otorhinolaryngology, Head and Neck DiseasesRegional differences of tracheostomy in extremely premature neonates across the United States
2022, International Journal of Pediatric OtorhinolaryngologyComplications of tracheostomy in children: a systematic review
2022, Brazilian Journal of OtorhinolaryngologySurgical Support of the Developmentally Delayed or Neurologically Impaired Child
2022, Surgical Clinics of North America