Abstract
Forty-four children (25 males and 19 females) under 6 years old undergoing tracheostomy at Kurashiki Central Hospital between 2004 and 2009 were retrospectively reviewed. Twenty-eight cases were less than one year old when they underwent the tracheostomy. The indications of the tracheostomies were upper airway obstruction in 17 cases and respiratory management in 27 cases. Tracheostomies were performed with vertical skin incisions, and tracheal incisions were also made vertically except in two cases. Retention sutures were placed through the tracheal wall and skin on both sides of the tracheostomy orifices and secured until the stomas were stabilized to aid changing of the tracheostomy cannula. The option of a cannula, which is generally easily inserted, was taken in children with weight over 3000g. Granulation developed in 10 cases (22.7%); however, no life-threatening complication from this was noted. Sixteen cases died of primary disease and decannulation was accomplished in 3 cases (6.8%). Eleven patients needed artificial ventilation and 8 patients still required oxygen inhalation either at the time of transfer or now.
Pediatric tracheostomies should be performed with full awareness of the differences between children and adults. In our study no complication led to death, but prognosis of tracheostomized children, especially infants, was poor and a number of cases needed assistance in breathing.
