Tracheotomy in the first year of life: outcomes in term infants, the Vanderbilt experience

Otolaryngol Head Neck Surg. 2006 Mar;134(3):365-9. doi: 10.1016/j.otohns.2005.11.020.

Abstract

Objective: In an era emphasizing critical care of preterm infants, we characterize the indications and outcomes of tracheotomies performed in the first year of life in term infants compared to preterm infants.

Methods: Retrospective study of 127 tracheotomies performed in the first year of life at a tertiary-care children's hospital between 1988-2004.

Results: Mean gestational ages of the term and preterm groups were 38.97 and 29.71 weeks, respectively (P < 0.001). Indications for tracheotomy were upper airway abnormalities in 53% for the term group. The number of subsequent airway procedures required was 1.39 in the term group, achieving decannulation in 36.3%, with a 20.5% mortality rate.

Conclusion: Compared to preterm infants, the term decannulation rate was favorable, as chronic lung disease was uncommon. However, non-tracheotomy-related mortalities remained high.

Significance: Tracheotomies are often performed for relief of upper airway obstruction, and congenital and acquired comorbidities not related to tracheotomy are associated with adverse outcomes in term infants.

Ebm rating: C-4.

Publication types

  • Comparative Study

MeSH terms

  • Airway Obstruction / congenital
  • Airway Obstruction / surgery
  • Bronchopulmonary Dysplasia / surgery
  • Cause of Death
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Heart Defects, Congenital / surgery
  • Humans
  • Infant
  • Infant, Newborn*
  • Infant, Premature*
  • Lung Diseases / prevention & control
  • Male
  • Postoperative Complications
  • Respiration, Artificial
  • Respiratory System Abnormalities / surgery
  • Retrospective Studies
  • Tracheotomy* / adverse effects
  • Treatment Outcome