ABSTRACT
INTRODUCCIÓN: La traqueotomía es un procedimiento poco frecuente en la Unidad de cuidados intensivos pediátricos (UCIP). Analizamos las complicaciones derivadas de la técnica, la mortalidad atribuible a la misma y la mortalidad global de los pacientes traqueotomizados. PACIENTES Y MÉTODOS: Estudio retrospectivo descriptivo durante el periodo comprendido entre enero del 2003 y diciembre del 2013 de los pacientes ingresados en la UCIP a los que se realiza una traqueotomía a lo largo de su ingreso. RESULTADOS: Durante el periodo analizado se recoge a 25 pacientes. La media de edad es de 31,3 meses (rango 1-144, mediana 14 meses) y la media de estancia en UCIP es de 53 días (rango 1-338 días, mediana 37 días). En su mayoría (68%) son pacientes con comorbilidades previas a su ingreso, destacando en frecuencia las anomalías craneofaciales/síndromes polimalformativos (32%) y problemas asociados a la prematuridad (12%). Las patologías más frecuentes que motivaron la realización del procedimiento fueron la obstrucción congénita de la vía aérea y diversas causas de lesión medular, seguido de traqueobroncomalacia y estenosis subglótica. Se detectaron complicaciones en el 40% de los pacientes, siendo la más frecuente la decanulación accidental. Presentaron durante el curso evolutivo una decanulación accidental el 20% de los pacientes, principalmente en las primeras 24 h del postoperatorio, motivo por el que falleció uno de los pacientes. CONCLUSIONES: La realización de la traqueotomía es un procedimiento poco frecuente en la UCIP, aunque no exento de complicaciones, algunas de ellas de riesgo vital
INTRODUCTION: Tracheotomy in pediatric patients is a rare procedure. In this pediatric series, perioperative complications, mortality related to surgical procedure and overall mortality are analyzed. PATIENTS AND METHODS: This is a retrospective study conducted from January 2003 to December 2013. Data were retrieved from patients who were tracheotomized and admitted to our PICU in the postoperative period. RESULTS: Data were collected from 25 tracheotomized patients admitted during the study period. The mean age was 3.3 months (median 14 months, range 1-144 months), and PICU length of stay was 53 days (median 37 days, range 1-338 days). Most patients (68%) had comorbidities before their admission, with a higher prevalene of craniofacial anomalies/polymalformative syndromes (32%) and prematurity related disorders (12%) being obserevd. The most common etiologies related to the procedure were congenital airway obstruction (16%) and several types of spinal cord injury (16%), followed by tracheobronchomalacia (12%) and subglottic stenosis (12%). Some kind of complication was detected in 40% of patients, with accidental decannulation being the most frequent. Accidental or unexpected decannulation was present in a percentage as high as 20% of our patients, mainly in the first 24hours after surgery. One of the patients died as a result of this. CONCLUSIONS: The postoperative course of a tracheotomy is associated with a high rate of complications, some of them related to life-threatening events
Subject(s)
Humans , Male , Female , Child , Tracheotomy/adverse effects , Tracheotomy/methods , Tracheotomy/statistics & numerical data , Postoperative Complications/epidemiology , Postoperative Complications/mortality , Intensive Care Units, Pediatric/organization & administration , Intensive Care Units, Pediatric/statistics & numerical data , Intensive Care Units, Pediatric , Tracheotomy/instrumentation , Tracheotomy/mortality , Comorbidity , Retrospective StudiesABSTRACT
INTRODUCTION: Tracheotomy in pediatric patients is a rare procedure. In this pediatric series, perioperative complications, mortality related to surgical procedure and overall mortality are analyzed. PATIENTS AND METHODS: This is a retrospective study conducted from January 2003 to December 2013. Data were retrieved from patients who were tracheotomized and admitted to our PICU in the postoperative period. RESULTS: Data were collected from 25 tracheotomized patients admitted during the study period. The mean age was 3.3 months (median 14 months, range 1-144 months), and PICU length of stay was 53 days (median 37 days, range 1-338 days). Most patients (68%) had comorbidities before their admission, with a higher prevalene of craniofacial anomalies/polymalformative syndromes (32%) and prematurity related disorders (12%) being obserevd. The most common etiologies related to the procedure were congenital airway obstruction (16%) and several types of spinal cord injury (16%), followed by tracheobronchomalacia (12%) and subglottic stenosis (12%). Some kind of complication was detected in 40% of patients, with accidental decannulation being the most frequent. Accidental or unexpected decannulation was present in a percentage as high as 20% of our patients, mainly in the first 24 hours after surgery. One of the patients died as a result of this. CONCLUSIONS: The postoperative course of a tracheotomy is associated with a high rate of complications, some of them related to life-threatening events.
