ORIGINAL RESEARCH
Pediatric Tracheotomy: A Single Center Pediatric Cardiac Intensive Care Unit Experience
Pediatrik Trakeotomi: Tek Merkezli Pediatrik Kardiyoloji Yoğun Bakım Deneyimimiz
Received Date : 15 Aug 2019
Accepted Date : 26 Aug 2019
M. Volkan AKDOĞANa, Mahmut GÖKDEMİRb, Nimet CINDIKb, Özgül TOPALa
aKulak Burun Boğaz Hastalıkları Kliniği,
bÇocuk Sağlığı ve Hastalıkları Kliniği,
Başkent Üniversitesi Konya Uygulama ve Araştırma Merkezi, Ankara, TÜRKİYE
Doi: 10.24179/kbbbbc.2019-71016 - Makale Dili: TR
KBB ve BBC Dergisi 2019;27(2):63-9
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study was to provide a retrospective analysis of pediatric tracheotomies
performed in our hospital and to compare the findings with the literature and to identify
possible similar and different aspects. Material and Methods: Pediatric tracheotomies performed at
Başkent University Konya Training and Research Center between January 2015 and May 2019 were
reviewed retrospectively. All patients under 16 years of age who underwent tracheotomy were identified
from the hospital information system. The indications for tracheotomy, duration of intubation,
age and weight when tracheotomy was performed, complications, mortality and decannulation status
were examined. Results: A total of 35 patients underwent tracheotomy. Standard tracheotomy
procedure was performed for all patients. Fifteen (42.9%) of the patients were male and 20 (57.1%)
were female. Sixty percent of the patients (21 patients) had previous cardiac surgery. The mean age
was 13 months (1 month-90 months). 77% (27 patients) of the patients were under one year of age.
This rate was 80.9% in the group undergoing cardiac surgery. The mean weight of the patients was
6.192 gram during the procedure. The most common indication for tracheotomy was neurological
reasons (14 patients, 40%) followed by prolonged intubation (11 patients, 31.4%) and upper airway
obstruction (10 patients, 28.6%), respectively. Major complications were observed in 2 (5.7%) patients,
while mortality due to tracheotomy occurred in 1 (2.8%) patient. Conclusion: Especially in recent
years due to improvements in pediatric intensive care services pediatric tracheotomy become
frequently performed surgical procedure, In our patient group most common indication for tracheotomy
was neurological reasons. Prolonged intubation and upper airway obstruction were the indications
in patients undergoing cardiac surgery. While the major complication and mortality rates
in our patients were within acceptable limits, decanulation rates were found to be low.
Keywords: Tracheotomy; intensive care units; pediatric
ÖZET
Amaç: Bu çalışmada, hastanemizde gerçekleştirilmiş olan pediatrik trakeotomilerin retrospektif
analizi sağlanarak elde edilen bulguların literatürle karşılaştırılması ve olası benzer ve farklı yönlerin
ortaya konması hedeflenmiştir. Gereç ve Yöntemler: Başkent Üniversitesi Konya Eğitim ve
Araştırma Merkezi’nde Ocak 2015-Mayıs 2019 tarihleri arasında gerçekleştirilmiş olan pediatrik trakeotomiler
retrospektif olarak incelenmiştir. Hastane bilgi sisteminden, trakeotomi açılan 16 yaş altı
tüm hastalar tespit edilmiş; hastaların trakeotomi açılma endikasyonları, entübasyon süreleri, trakeotominin
açıldığı dönemdeki yaş ve kiloları, karşılaşılan komplikasyonlar, mortalite ve dekanülasyon
durumları incelenmiştir. Bulgular: Toplam 35 hastaya trakeotomi açıldığı tespit edildi. Tüm hastalara
standart trakeotomi prosedürü uygulandı. Hastaların 15 (%42,9)’i erkek, 20 (%57,1)’si ise kız idi. Hastaların
%60 (n=21)’ında geçirilmiş kardiyak cerrahi söz konusuydu. Ortalama yaş 13 ay (1-90 ay) idi.
Hastaların %77 (n=27)’si bir yaş altındaydı. Bu oran, kardiyak cerrahi geçiren grupta %80,9 idi. İşlem
sırasında hastaların ortalama kiloları 6,192 gram idi. En sık trakeotomi endikasyonu nörolojik nedenlere
bağlı olup (14 hasta; %40), bunu sırasıyla uzamış entübasyon (11 hasta; %31,4) ve üst hava yolu
obstrüksiyonu (10 hasta; %28,6) takip etmekteydi. İki (%5,7) hastada majör komplikasyon izlenirken,
trakeotomiye bağlı mortalite 1 (%2,8) hastada ortaya çıktı. Sonuç: Pediatrik trakeotomi işlemi, özellikle
son yıllarda pediatrik yoğun bakım hizmetlerindeki gelişmelerle daha sık ihtiyaç duyulan özellikli
bir cerrahidir. Bu çalışmada, hastalarımızda en sık trakeotomi endikasyonunun nörolojik
nedenlere bağlı olduğu, kardiyak cerrahi geçiren hastalarda ise uzamış entübasyon ve üst havayolu tıkanıklığının
etiyolojide yer aldığı tespit edilmiştir. Majör komplikasyon ve mortalite oranlarımız kabul
edilebilir sınırlarda iken dekanülasyon oranlarımızın düşük olduğu görülmüştür.
Anahtar Kelimeler: Trakeotomi; yoğun bakım; pediatrik
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