Evaluation of Early-term Results of Cuffed/Non-cuffed Tracheostomy Tubes in Infants and Children for Tracheostomy Procedure
PDF
Cite
Share
Request
Research Article
P: 148-153
June 2023

Evaluation of Early-term Results of Cuffed/Non-cuffed Tracheostomy Tubes in Infants and Children for Tracheostomy Procedure

J Ankara Univ Fac Med 2023;76(2):148-153
1. Mersin Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Mersin, Türkiye
No information available.
No information available
Received Date: 15.04.2023
Accepted Date: 15.06.2023
Publish Date: 31.07.2023
PDF
Cite
Share
Request

ABSTRACT

Objectives:

Deciding to choose cuffed or uncuffed tubes in tracheostomy applications is also a topic of debate in children. The aim was determining the standards of tracheostomy procedure by evaluating the early term results in children.

Materials and Methods:

Patients who underwent elective tracheostomy procedures between January 2018- January 2023 were included. The ages of the patients, the duration of preoperative intubation, the types of tracheostomy tubes, and the early postoperative complications were examined. The patients were grouped as infants (1-12 months) and children (1-18 years) according to their age and cuffed and uncuffed tube group according to the tracheostomy tube type. The distribution of postoperative complications between age groups and tube-types was examined. Postoperative complications were also investigated according to preoperative intubation time.

Results:

A total of 43 patients: 24 (55.8%) in the infant age group and 19 (44.1%) in the pediatric age group. According to tracheostomy tube types: 21 (48.8%) were cuffed and 22 (51.2%) were uncuffed. Preoperative intubation time was 33.6±2.03 (minimum: 12, maximum: 113) days. Fourteen patients had postoperative complications. Preoperative intubation time was significantly longer in the infant age group than in the pediatric age group (p=0.041). There was a significant relationship between postoperative complications in the infant age group, and cuffed groups (p<0.001).

Conclusion:

The results obtained in the study suggest that by reducing the preoperative intubation time, early postoperative complications after tracheostomy can be reduced. In addition, it is thought that cuffed tracheostomy cannulas can be used safely in the early postoperative period in children.

Keywords: Tracheostomy, Infant, Child, Cuffed, Uncuffed

References

1
Greaney D, Russell J, Dawkins I, et al. A retrospective observational study of acquired subglottic stenosis using low-pressure, high-volume cuffed endotracheal tubes. Paediatr Anaesth. 2018;28:1136-1141.
2
Sathyamoorthy M, Lerman J, Asariparampil R, et al. Stridor in Neonates After Using the Microcuff and Uncuffed Tracheal Tubes: A Retrospective Review. Anesth Analg. 2015;12:1321-1324.
3
Watters KF. Tracheostomy in Infants and Children. Respir Care. 2017;62:799-825.
4
Ergün E, Ateş U, Selvi Can Ö, et al. A new trick for percutaneous tracheostomy in children. Journal of Ankara University Faculty of Medicine. 2020;73:70-72.
5
Graham RJ, Rodday AM, Parsons SK. Family-centered assessment and function for children with chronic mechanical respiratory support. J Pediatr Health Care. 2014;28:295-304.
6
Campisi P, Forte V. Pediatric tracheostomy. Semin Pediatr Surg. 2016;25:191-195.
7
Kobashi Y, Matsushima T. Clinical analysis of patients requiring long-term mechanical ventilation of over three months: ventilator-associated pneumonia as a primary complication. Intern Med. 2003;42:25-32.
8
Nafiu OO, Mpody C, Kirkby SE, et al. Association of preoperative pneumonia with postsurgical morbidity and mortality in children. Anesth Analg. 2021;132:1380-1388.
9
Remz M, Luria I, Gravenstein M, et al. Prevention of airway fires: do not overlook the expired oxygen concentration. Anesth Analg. 2013;117:1172-1176.
10
Pacheco AE, Leopold E. Tracheostomy in children: Recommendations for a safer technique. Semin Pediatr Surg. 2021;30:151054.
11
Bhardwaj N. Pediatric cuffed endotracheal tubes. J Anaesthesiol Clin Pharmacol. 2013;29:13-18.
12
Volsko TA, Parker SW, Deakins K, et al. AARC clinical practice guideline: management of pediatric patients with tracheostomy in the acute care setting. Respir Care. 2021;66:144-155.
13
Smith MM, Benscoter D, Hart CK. Pediatric tracheostomy care updates. Curr Opin Otolaryngol Head Neck Surg. 2020;28:425-429.
14
Cole F. Pediatric Formulas for the anesthesiologist. Arch Pediatr Adolesc Med. 1957;94:672-673.
15
Jobe AH, Bancalari E.Bronchopulmonary dysplasia. American Journal of Respiratory and Critical Care Medicine. 2001;163:1723-1729.
16
Barret JP, Desai MH, Herndon DN. Effects of tracheostomies on infection and airway complications in pediatric burn patients. Burns J Int Soc Burn Inj. 2000;26:190-193.
17
Lee W, Koltai P, Harrison AM, et al. Indications for tracheotomy in the pediatric intensive care unit population. Arch Otolaryngol Head Neck Surg. 2002;128:1249-1252.
18
Holloway AJ, Spaeder MC, Basu S. Association of timing of tracheostomy on clin- ical outcomes in PICU patients. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2015;16:52-58.
19
Watters K, O’Neill M, Zhu H, et al. Two-year mortality, complications, and healthcare use in children with medicaid following tracheostomy. Laryngoscope. 2016;126:2611-2617.
20
Schlessel JS, Harper RG, Rappa H, et al. Tracheostomy: acute and long-term mortality and morbidity in very low birth weight premature infants. J Pediatr Surg. 1993;28:873-876.
21
Orliaguet GA, Renaud E, Lejay M, et al. Postal survey of cuffed or uncuffed tracheal tubes used for paediatric tracheal intubation. Paediatr Anaesth. 2001;11:277-281.
22
De Orange FA, Andrade RG, Lemos A, et al. Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. Cochrane Database Syst Rev. 2017;11:CD011954.
23
Lubianca Neto JF, Castagno OC, Schuster AK. Complications of tracheostomy in children: a systematic review. Braz J Otorhinolaryngol. 2022;88:882-890.
24
Garcia-Urabayen D, López-Fernandez YM, Pilar-Orive J, et al. Analysis of tracheostomies in a pediatric intensive care unit during the period 2003-2013. An Pediatr (Barc). 2016;84:18-23.
25
Colman KL, Mandell DL, Simons JP. Impact of stoa maturation on pediatric tracheostomy-related complications. Arch Otolaryngol Head Neck Surg. 2010;136:471-474.
26
Chang J, Sidell DR. Tracheostomy in Infants in the Neonatal Intensive Care Unit. Neoreviews. 2020;21:323-334.
27
Woods R, Geyer L, Mehanna R, et al. Pediatric tracheostomy first tube change: when is it safe? Int J Pediatr Otorhinolaryngol. 2019;120:78-81.
28
Backman S, Björling G, Johansson UB, et al. Material wear of polymeric tracheostomy tubes: a six-month study. Laryngoscope. 2009;119:657-664.
29
Yaremchuk K. Regular tracheostomy tube changes to prevent formation of granulation tissue. Laryngoscope. 2003;113:1-10
2024 ©️ Galenos Publishing House