Pediatric tracheotomies: a 37-year experience in 282 children.

OBJECTIVE: To study the outcomes, complications, and indications for pediatric tracheotomies performed at a tertiary referral center.

METHODS: A retrospective review of hospital records from 1968 to 2005 was conducted to assess all pediatric patients who had undergone tracheotomies.

RESULTS: A total of 282 tracheotomies were performed on patients under 16 years of age. The median age at tracheotomy was 27 months. Upper airway obstruction (infectious diseases, n=101; laryngeal anomalies, n=33; trauma, n=36; tumor, n=33) was the most common indication for tracheotomy (n=203; 72%). Lesser number of patients (n=79; 28%) required tracheotomy for prolonged ventilation. Decannulation was carried out successfully in 71 patients (35%). Total complication rate was 18%; only three patients (1%) died from tracheotomy-related complications, with an overall mortality rate of 19%.

CONCLUSIONS: Pediatric tracheotomies were associated with a low incidence of procedure-related mortality and morbidity and successful decannulation in 35% of cases. The majority of procedures were performed due to upper airway obstruction which were most commonly caused by infectious diseases.