TY - JOUR
T1 - Tracheostomy in Preterm Infants
T2 - Current Trends
AU - Pereira, Kevin D.
AU - MacGregor, Allison R.
AU - McDuffie, Chad M.
AU - Mitchell, Ron B.
PY - 2003/12
Y1 - 2003/12
N2 - Objective: To study the indications for and outcomes of tracheostomy in a population of preterm infants. Design: Retrospective analysis of case records. Setting: Two university-affiliated tertiary care children's hospitals. Patients: We identified premature infants who required tracheostomies from January 1, 1997, through January 31, 2001. Information on weight, gestational age, comorbid conditions, indication for tracheostomy, and outcomes was collected. Infants were divided by birth weight into group 1 (<1000 g; n=19 [very low birth weight]) and group 2 (≥1000 g; n=14). Comorbid conditions were scored and a total score was calculated for each patient. Results: Group 1 had a higher incidence of patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity. The incidence of congenital or genetic defects was equal in groups 1 and 2 (11 infants [58%] and 8 infants [57%1, respectively). Group 1 had a higher average number of failed extubations (5.17 vs 3.18) and a higher oxygen requirement (48.7% vs 30.3%) compared with group 2. Weight at tracheostomy was essentially equal in groups 1 and 2 (3.6 vs 3.7 kg). Subglottic stenosis and laryngotracheomalacia were equally common findings in groups 1 and 2. The average comorbidity score for group 1 was higher than that for group 2 (6.7 vs 2.8). The most common indication for tracheostomy was ventilatory dependence (n=24 [73%]), compared with airway obstruction (n=6 [18%]) and pulmonary toilet (n=3 [9%]). Overall, 6 patients (18%) had a complication related to the tracheostomy. Conclusions: Severity of pulmonary disease was the most significant factor associated with the need for tracheostomy in preterm infants. A tracheostomy can safely be performed in these infants with minimal morbidity.
AB - Objective: To study the indications for and outcomes of tracheostomy in a population of preterm infants. Design: Retrospective analysis of case records. Setting: Two university-affiliated tertiary care children's hospitals. Patients: We identified premature infants who required tracheostomies from January 1, 1997, through January 31, 2001. Information on weight, gestational age, comorbid conditions, indication for tracheostomy, and outcomes was collected. Infants were divided by birth weight into group 1 (<1000 g; n=19 [very low birth weight]) and group 2 (≥1000 g; n=14). Comorbid conditions were scored and a total score was calculated for each patient. Results: Group 1 had a higher incidence of patent ductus arteriosus, bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity. The incidence of congenital or genetic defects was equal in groups 1 and 2 (11 infants [58%] and 8 infants [57%1, respectively). Group 1 had a higher average number of failed extubations (5.17 vs 3.18) and a higher oxygen requirement (48.7% vs 30.3%) compared with group 2. Weight at tracheostomy was essentially equal in groups 1 and 2 (3.6 vs 3.7 kg). Subglottic stenosis and laryngotracheomalacia were equally common findings in groups 1 and 2. The average comorbidity score for group 1 was higher than that for group 2 (6.7 vs 2.8). The most common indication for tracheostomy was ventilatory dependence (n=24 [73%]), compared with airway obstruction (n=6 [18%]) and pulmonary toilet (n=3 [9%]). Overall, 6 patients (18%) had a complication related to the tracheostomy. Conclusions: Severity of pulmonary disease was the most significant factor associated with the need for tracheostomy in preterm infants. A tracheostomy can safely be performed in these infants with minimal morbidity.
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U2 - 10.1001/archotol.129.12.1268
DO - 10.1001/archotol.129.12.1268
M3 - Article
C2 - 14676150
AN - SCOPUS:0348111508
SN - 0886-4470
VL - 129
SP - 1268
EP - 1271
JO - Archives of Otolaryngology - Head and Neck Surgery
JF - Archives of Otolaryngology - Head and Neck Surgery
IS - 12
ER -