Indications for tracheotomy in the pediatric intensive care unit population: a pilot study.

@article{Lee2002IndicationsFT,
  title={Indications for tracheotomy in the pediatric intensive care unit population: a pilot study.},
  author={Walter T. Lee and Peter J. Koltai and A. Marc Harrison and Elumalai Appachi and Demetrios Bourdakos and Steve Davis and Kathryn L. Weise and Michael McHugh and Jason T. Connor},
  journal={Archives of otolaryngology--head \& neck surgery},
  year={2002},
  volume={128 11},
  pages={
          1249-52
        }
}
OBJECTIVE To define the indications for tracheotomy in patients requiring prolonged intubation (>1 week) in the pediatric intensive care unit (PICU). DESIGN Retrospective chart review and follow-up telephone survey. SETTING A tertiary care center PICU. OUTCOME MEASURE Tracheotomy or extubation. PATIENTS All patients older than 30 days in the PICU intubated for longer than 1 week between 1997 and 1999. RESULTS During the study, 63 total admissions required intubation for longer than 1… 

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References

SHOWING 1-10 OF 11 REFERENCES

Late complications of prolonged tracheal intubation

It is concluded thattracheal tubes can be left in place for seven days and at this time direct laryngoscopy should be done and if no significant laryngeal pathology is seen at this examination, tracheal intubation may be continued.

Tracheotomy in infants and young children: The changing perspective 1970–1985

Improvements in medical management resulted in prolonged survival of children with multiple abnormalities and resulted in more prolonged tracheotomies, and basic fundamentals of pediatric tracheotomy management remain unchanged.

Starplasty: a new technique of pediatric tracheotomy.

  • P. Koltai
  • Medicine
    Archives of otolaryngology--head & neck surgery
  • 1998
It is concluded that starplasty reduces the incidence of major complications and death, and its only drawback seems to be persistent tracheocutaneous fistula.

Intubation of critically ill patients.

A comparative analysis of endotracheal intubation in neonates, children and adults: Complications, prevention and treatment

The use of endotracheal tube to provide a prolonged airway and as an adjunct to artificial ventilation continues to be a controversial subject and primary and secondary tracheostomies were evaluated as to mortality, morbidity, and complications.

Untoward sequelae of prolonged intubation

After reviewing the records of 372 consecutive patients intubated over an 18‐month period, an increased frequency of laryngeal sequelae following prolonged endotracheal intubation is observed in the diabetic female patient and it is suggested that early tracheostomy should be considered in these individuals when the use of prolonged intubations is anticipated.

A prospective study of laryngotracheal sequelae in long‐term intubation

A series of 200 patients having endotracheal intubation between 2 and 24 days were studied prospectively and showed clear trends in survival and morbidity.

Hyaline membrane disease of the neonate prolonged intubation in management: Effects on the larynx

  • Donald B. Hawkins
  • Medicine
    The Laryngoscope
  • 1978
Hyaline membrane disease, an illness of premature neonates, is associated with 20–30% of all neonatal deaths and 50–70% of premature deaths in the United States. Often related to perinatal hypoxia,

Pediatric Tracheotomies: Changing Indications and Outcomes

To study the outcomes and complications associated with pediatric tracheotomy, as well as the changing trend in indications and outcomes since 1970, a large number of children are treated with tracheotomies.

Risk Factors for Neonatal Acquired Subglottic Stenosis

It is concluded that endotracheal intubation is an appropriate means of long-term airway management in neonates hospitalized in a pediatric intensive care unit, providing other known risk factors are minimized.