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Tracheostomy in infants in an Australian Tertiary Children’s Hospital: have the indications and outcomes changed?

Published online by Cambridge University Press:  28 October 2024

Katryna Pham Open the ORCID record for Katryna Pham [Opens in a new window] ,
Emma Ho ,
Beckie Petulla ,
Ju-lee Oei ,
Hari Ravindranathan  and
Marlene Soma Open the ORCID record for Marlene Soma [Opens in a new window]
Katryna Pham
Affiliation:
School of Clinical Medicine, Women’s Health, Paediatrics & Children’s Health, University of New South Wales, Randwick, NSW, Australia
Emma Ho
Affiliation:
Department of Paediatric Otolaryngology, Sydney Children’s Hospital, Randwick, NSW, Australia
Beckie Petulla
Affiliation:
Complex and Artificial Airways Clinical Nurse Consultant, Sydney Children’s Hospital, Randwick, NSW, Australia
Ju-lee Oei
Affiliation:
School of Clinical Medicine, Women’s Health, Paediatrics & Children’s Health, University of New South Wales, Randwick, NSW, Australia Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia
Hari Ravindranathan
Affiliation:
School of Clinical Medicine, Women’s Health, Paediatrics & Children’s Health, University of New South Wales, Randwick, NSW, Australia Paediatric Intensive Care Unit, Sydney Children’s Hospital, Randwick, NSW, Australia
Marlene Soma*
Affiliation:
School of Clinical Medicine, Women’s Health, Paediatrics & Children’s Health, University of New South Wales, Randwick, NSW, Australia Department of Paediatric Otolaryngology, Sydney Children’s Hospital, Randwick, NSW, Australia
*
Corresponding author: Marlene Soma; Email: [email protected]
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Abstract

Objectives

To determine if there have been changes over time for indications and outcomes of tracheostomies in infants.

Methods

Retrospective review of infant tracheostomies at a tertiary children’s hospital across two time periods (epoch 1: 1997–2008; epoch 2: 2009–2020). Patient demographics, tracheostomy indications, comorbidities, length of stay, complications, decannulation and mortality were examined.

Results

Seventy-two infants had a tracheostomy (40 epoch 1 vs 32 epoch 2). Airway obstruction decreased (80 per cent vs 50 per cent*) and long-term ventilation increased (17.5 per cent vs 40.6 per cent*) as the primary indication. Early complications decreased between the time periods (30 per cent vs 6.3 per cent*). The median hospital length of stay was 97 days (interquartile range 53–205.5), total complication rate was 53 per cent, decannulation rate was 61 per cent and mortality rate was 17 per cent (all non-tracheostomy related) across both time periods. There were no significant changes for these outcomes. *(p< 0.05)

Conclusion

Long-term ventilation has increased and airway obstruction has decreased as the primary indication for infant tracheostomy over time.

Keywords

TracheostomyInfantAirway obstructionPediatricsVentilation
Type
Main Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 9
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Marlene Soma takes responsibility for the integrity of the content of the paper Presented at the 72nd Australian Society of Otolaryngology Head Neck Surgery Annual Scientific Meeting in Adelaide, Australia 10–12 June 2022.

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