TY  - BOOK
AU  - Moyer, Kelly
TI  - Current Trends in Neonatal Tracheostomy
SN  - 2168-6181
PY  - 2016///
KW  - *Tracheostomy/sn [Statistics & Numerical Data]
KW  - Airway Obstruction/th [Therapy]
KW  - Birth Weight
KW  - Craniofacial Abnormalities/th [Therapy]
KW  - Female
KW  - Humans
KW  - Infant
KW  - Infant, Newborn
KW  - Laryngostenosis/th [Therapy]
KW  - Male
KW  - Respiratory Insufficiency/th [Therapy]
KW  - Retrospective Studies
KW  - MedStar Washington Hospital Center
KW  - Otolaryngology
KW  - Journal Article
N2  - CONCLUSIONS AND RELEVANCE: Anatomical upper airway obstruction may be returning as the most common indication for a neonatal tracheostomy, thereby supporting the belief that current respiratory therapies have lowered the burden of chronic lung disease and the need for prolonged ventilatory care; DESIGN, SETTING, AND PARTICIPANTS: This retrospective medical record review included 47 neonates who underwent tracheostomy from January 1, 2009, to December 31, 2013, at the University of Maryland Children's Hospital. Group 1 included infants undergoing tracheostomy for the primary indication of upper airway obstruction; group 2, infants with primary pulmonary disease. Data on weight, gestational age, comorbid conditions, congenital abnormalities, complications, outcomes, and indications for tracheostomy were compared statistically between groups; IMPORTANCE: The indications for neonatal tracheostomy may have changed with current noninvasive respiratory therapies compared with previous decades; MAIN OUTCOMES AND MEASURES: Differences in gestational age, birth weight, and age at tracheostomy; OBJECTIVES: To study the current trends in neonatal tracheostomy and identify the primary indication for the procedure and risk factors for failed extubation; RESULTS: Among the 47 infants included in the study (30 boys; 17 girls, mean [SD] age, 113 [73] days), 31 (66%) demonstrated anatomical causes of airway obstruction, and 16 (34%) had significant pulmonary disease. Among infants with anatomical causes, subglottic stenosis represented the largest group (11 of 31 [35%]). The mean age at the time of tracheostomy was significantly lower in the group with airway obstruction (98.9 vs 146.9 days; difference, 48 [95% CI, 4.8-91.2] days; P=.04). No procedure-related morbidity or mortality was encountered
UR  - https://dx.doi.org/10.1001/jamaoto.2016.1107
ER  -