Title

Acute Post-Tracheostomy Clinical Decompensations in Infants-Are There Predictive Markers?

Document Type

Article

Publication Date

10-2018

Identifier

DOI: 10.1055/s-0038-1642061

Abstract

OBJECTIVE: To report on the population of infants receiving a tracheostomy, identify acute post-tracheostomy clinical decompensations, and seek predictive markers associated with acute complications following the placement of a tracheostomy.

STUDY DESIGN: Retrospective deidentified clinical data was provided by the Infant Pulmonary Data Repository at Children's Mercy Hospital, Kansas City. Data from infants undergoing tracheostomy from January 1, 2008 through September 30, 2016 were divided into one of two study groups based on clinical correlations: (1) no acute decompensations within 72 hours post-tracheostomy or (2) acute clinical decompensation defined as sustained escalation of respiratory care within the 72 hours following tracheostomy.

RESULTS: Thirty-four percent of infants undergoing tracheostomy during this period developed acute post-tracheostomy clinical decompensations. Elevated pre-tracheostomy positive end expiratory pressure, mean airway pressure, and echocardiogram findings suggestive of pulmonary hypertension (PH) or ventricular dysfunction were associated with acute post-tracheostomy clinical decompensations. Additionally acute post-tracheostomy clinical decompensation was associated with higher rate of death prior to discharge.

CONCLUSION: Infants requiring higher respiratory support and infants with PH or ventricular dysfunction are at risk of acute post-tracheostomy clinical decompensation, thus identifying these patients may lead to better pre-tracheostomy counseling and potentially targeted treatments to decrease this risk.

Journal Title

American journal of perinatology

Volume

35

Issue

12

First Page

1206

Last Page

1212

MeSH Keywords

Bronchopulmonary Dysplasia; Echocardiography; Female; Hospital Mortality; Humans; Hypertension, Pulmonary; Infant; Infant, Newborn; Male; Missouri; Positive-Pressure Respiration; Postoperative Complications; Respiratory Therapy; Retrospective Studies; Time Factors; Tracheostomy; Ventricular Dysfunction

Keywords

Bronchopulmonary Dysplasia; Echocardiography; Female; Hospital Mortality; Humans; Hypertension, Pulmonary; Infant; Infant, Newborn; Male; Missouri; Positive-Pressure Respiration; Postoperative Complications; Respiratory Therapy; Retrospective Studies; Time Factors; Tracheostomy; Ventricular Dysfunction

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