Current Trends in Neonatal Tracheostomy.
Citation: JAMA Otolaryngology-- Head & Neck Surgery. 142(8):738-42, 2016 Aug 01PMID: 27281282Institution: MedStar Washington Hospital CenterDepartment: OtolaryngologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Tracheostomy/sn [Statistics & Numerical Data] | Airway Obstruction/th [Therapy] | Birth Weight | Craniofacial Abnormalities/th [Therapy] | Female | Humans | Infant | Infant, Newborn | Laryngostenosis/th [Therapy] | Male | Respiratory Insufficiency/th [Therapy] | Retrospective StudiesYear: 2016ISSN:- 2168-6181
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 27281282 | Available | 27281282 |
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.
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