Pediatric tracheostomy – A 3 year retrospective study - Timisoara „Louis Turcanu” Emergency Hospital for Children experience

Introduction Given the high rate of morbidity and mortality of tracheostomy in children, surgery is considered difficult. The paper presents the management and technical difficulties of pediatric tracheostomy.

Material and method In the „ Louis Turcanu” Emergency Hospital for Children Timisoara, between 2016 and 2019, 36 tracheotomies were performed in children aged between 1 and 17 years. Tracheostomy indications were for upper airway obstruction, assisted ventilation, or pulmonary lavage. Different types of tracheal cannula were used. The choice of cannula should take into account the indication of the tracheotomy. The ideal cannula should be silicone, easy to clean and available in different sizes.

Results Horizontal lower cervical incision was performed to all tracheostomies. General anesthesia with orotracheal intubation probe was used, the cervical region being in hyperextension. Intraoperative complications were minimal: slight bleeding and tracheal cannula problems. Postoperative complications manifested as: accidental decanulation, subcutaneous emphysema, feeding difficulties, infection.

Conclusions Tracheostomy is considered a life-threatening intervention, with no absolute contraindications.It is a difficult intervention because of the anatomical features at these ages.

The tracheostomy should be performed in controlled situations with orotracheal intubation on the probe or bronchoscope. The rate of complications of tracheotomy in children can be around 40 %.

Keywords tracheostomy, child, cannula, complications

Publication History

Article published online:
10 June 2020