Respiratory, growth, and survival outcomes of infants with tracheostomy and ventilator dependence.

Creator(s)

Gangaram Akangire, Children's Mercy HospitalFollow
Jane B Taylor
Susan McAnany, Children's Mercy HospitalFollow
Janelle R. Noel-Macdonnell PhD, Children's Mercy HospitalFollow
Charisse I. Lachica, Children's Mercy HospitalFollow
Venkatesh Sampath, Children's Mercy HospitalFollow
Winston M. Manimtim, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

8-2021

Identifier

DOI: 10.1038/s41390-020-01183-x; PMCID: PMC7605149

Abstract

BACKGROUND: Outcome of infants with tracheostomy have not been well described in the literature. Our objective was to describe the respiratory, growth, and survival outcomes of infants with tracheostomy.

METHODS: A retrospective study was conducted on 204 infants born between 2005 and 2015 with tracheostomy atage.

RESULTS: The mean age at tracheostomy was 4.5 months with median age of 3 months. Median age of decannulation was 32 months. The time from tracheostomy placement to complete discontinuation of mechanical ventilation was 15.4 months and from tracheostomy to decannulation was 33.8 months. Mortality rate was 21% and median age of death was 18 months. Preterm infants with acquired airway and lung disease (BPD) and born atweeks' gestation had a significantly higher survival rate compared to term infants. The z-scores for weight and weight for length improved from the time of discharge (mean chronological age 6.5 months) to first year and remained consistent through 3 years.

CONCLUSIONS: Premature infants had a higher rate of discontinuation of mechanical ventilation and decannulation compared to term infants. These infants showed consistent growth and comparable survival rate.

IMPACT: Infants with tracheostomy and ventilator dependence followed in a multidisciplinary clinic model may have improved survival, growth, and earlier time to decannulation. Preterm infants with acquired airway and lung disease (BPD) with tracheostomy had a higher survival rate compared to term infants with various tracheostomy indications. The age at tracheostomy in infants was 4.5 months and of decannulation was 37 months. Time from tracheostomy to complete discontinuation of mechanical ventilation was 15.4 months. Addition of this data to the sparse literature will be crucial in counseling the families and education of medical staff.

Journal Title

Pediatric research

Volume

90

Issue

2

First Page

381

Last Page

389

Recommended Citation

Akangire G, Taylor JB, McAnany S, et al. Respiratory, growth, and survival outcomes of infants with tracheostomy and ventilator dependence. Pediatr Res. 2021;90(2):381-389. doi:10.1038/s41390-020-01183-x