ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Indications and results of tracheostomy in pediatric postoperative intensive care unit
Yavuz Enç1, Numan Aydemir1, Yeşim Biçer2, Nurgül Yurtseven2, Gökcen Orhan1, Batuhan Özay1, Umut Ayoglu1, Alper Görür1, Fırat Altın1, Sertaç Çiçek1
1Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
2Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul
Background: Early extubation after cardiac surgery is the safest and desirable approach. But it is not always possible in infants and children and entubation times get longer. Tracheostomy is the alternative approach in these cases. However, there is still no consensus about the indications and results of tracheostomy in children after cardiac surgery. The aim of the present study is to report our experience and review the literature.

Methods: Tracheostomy was required in 19 patients in the pediatric postoperative intensive care unit between February 2002 and November 2005. The clinical data of these patients were collected prospectively and evaluated in the present study.

Results: The mean entubation time before the tracheostomy was 25.1±11 days. When regarding the cases in which decannulation had been possible, the mean time between performing tracheostomy and decannulation was 23.3±10 days and the mean total mechanic ventilation time was 48.6±14.3 days. The mean intensive care unit stay time was 55.8±17.3 days and the mean hospitalization time was 71.6±34.6 days in these patients. Seven cases died and hospital mortality in these patients was 37%. When regarding two patients who died after hospital discharge, total mortality was 48% in patients with tracheostomy. Nine cases are still alive 16.8±12.2 months after surgery and none of them suffered from late complications of tracheostomy such as tracheal stenosis or stridor.

Conclusion: Tracheostomy in pediatric cases in whom entubation time gets longer after cardiac surgery is a safe alternative approach and can be applied safely and without spending extra time in cases with expected long entubation time.

Keywords : Thoracic surgery; tracheostomy; pediatrics
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