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- Title
Tracheostomy in the neonatal intensive care unit: Five-year experience.
- Authors
Atay, Funda Yavanoğlu; Altıok, Fatma; Çolak, Derya; Şahin, Özlem; Güran, Ömer; Önder, Serap Şahin; Akın, İlke Mungan
- Abstract
Objective: It is seen that the majority of tracheostomies in the pediatric age group occur under the age of 1, especially in neonatal intensive care (NICU) or after pediatric intensive care transfers. In this study, we wanted to present our tracheostomy experience and indications in our long-term follow-up. Material and Methods: In this study, the retrospective records of patients who were hospitalized in the NICU of our hospital and underwent tracheostomy between January 2017 and December2021 were reviewed. Patients were divided into two groups according to tracheostomy indications. Results: A total of 28 patients were included in the study. Eight patients (28%) were tracheostomized due to upper airway disease (Group 1), and 20 patients (72%) due to prolonged mechanical ventilation (Group 2). There was no difference between the median week of birth and birth weights between the two groups (37 weeks [32–39] 2825 g [1500–3400] and 36 weeks [24–41], 2320 g [465–3925], respectively) (p>0.05). Although the median number of postnatal days with mechanical ventilator and tracheostomy before tracheostomy was lower in patients with upper airway stenosis, it was not statistically significant (26 days [6–126] -94 days [21–260] and 53 days [30–75]-116 days [48–159], respectively) (p=0.08). While the need for mechanical ventilator in the postoperative period of 6 (75%) patients who were tracheostomized due to upper airway stenosis disappeared, only 2 (11.8%) patients in Group 2 did not need it (p=0.04). While no mortality was observed in tracheostomy patients due to upper airway stenosis, the mortality rate in Group 2 was quite high (63.3%) (p=0.03). Conclusion: Although the indication for tracheostomy in the neonatal period has increased due to medical developments in the last decade, it is not widely used. While indications and durations were based on certain criteria in adult and pediatric intensive care tracheostomy studies, no such literature data on the neonatal period could be reached. In our study, in parallel with the literature, the number of days for tracheostomy was found to be quite high compared to the number of days in ICU and PICU. We think that early tracheostomy would be beneficial for mortality and long-term morbidity, especially in neonatal patients with upper airway stenosis and surgical inconvenience or failure.
- Subjects
TURKEY; MORTALITY risk factors; TRACHEOTOMY; PATIENT aftercare; RESPIRATORY diseases; NEONATAL intensive care; AIRWAY (Anatomy); NEONATAL intensive care units; RETROSPECTIVE studies; ACQUISITION of data; GESTATIONAL age; ARTIFICIAL respiration; MEDICAL records; BIRTH weight; HOSPITAL care of children
- Publication
Ümraniye Pediatri Dergisi, 2022, Vol 2, Issue 3, p87
- ISSN
2757-7074
- Publication type
Article
- DOI
10.14744/upd.2023.57966