Abstract

FRANCHI, Rodrigo et al. Tracheotomy in a critically ill patient: 25 years experience in the Pediatric Intensive Care Unit. Arch. Pediatr. Urug. [online]. 2016, vol.87, n.2, pp.95-98. ISSN 0004-0584.

Summary  Tracheotomy in critical pediatric patients is a frequent procedure. Indications are gradually more precise and its performance and the delayed extubating demand reflection given its mortality and morbility rates. Objectives: to evaluate the indication of tracheotomy in the PICU throughout 25 years. Method: retrospective, descriptive study of children who underwent tracheotomy at the PICU at the Asociación Española between January 1, 1990 and January 31, 2015. Results: during the above mentioned period 4290 patients were discharged from the PICU, 29 of whom underwent tracheotomy, all of which required invasive MV. 59% of them were younger than one year old. The most frequent causes for tracheotomy were neurological disease (37%), malformation (34%), and post-intubation subglottic stenosis (20%). An average of 3 extubation attempts were made before surgery in 89% and in 59% prior endoscopies were performed. Cannulas were removed in six out of the 28 patients who were discharged alive, 8 still have the tracheotomy, 4 died and evolution is not known in 8 patients. Conclusions: incidence of this procedure in the ICU, where this study was conducted was low and the fact that it was always associated to children who required MV constitutes a quality index in the handling of airways and in terms of usefulness of non-invasive ventilation as a way to avoid the most frequent complication referred in the literature: postintubation subglottic stenosis, as there is no need to perform it.

Keywords : TRACHEOSTOMY; CRITICAL CARE.

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