Outcomes of Tracheostomy in Children Requiring Surgery for Congenital Heart Disease.
Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children(33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half. Median time between cardiac surgery and tracheostomy was 58 days. The most common indication for tracheostomy was multifactorial (30%) followed by airway malacia (22%). Median length to follow-up for survivors was 3.9 years (range 0.4-11.8 years). Survival to hospital discharge was 72%, and intermediate survival was 48%. Survival in those with systemic to pulmonary artery shunts at the time of tracheostomy was 22% compared to 59% for those with biventricular anatomy. Heart failure and multiple indications for tracheostomy were associated with worse outcome. There was no difference in survival for those discharged with a ventilator compared to those that were not. The most common cause of death after discharge was tracheostomy tube dislodgement/obstruction, accounting for 5 of 11 that died. Survival with a tracheostomy after cardiac surgery is poor, and children with systemic to pulmonary artery shunts are at especially high risk of death.
Adolescent; Cardiac Surgical Procedures; Cause of Death; Child; Child, Preschool; Female; Heart Defects, Congenital; Heart Failure; Humans; Infant; Kaplan-Meier Estimate; Length of Stay; Male; Postoperative Complications; Respiration, Artificial; Retrospective Studies; Risk Factors; Time Factors; Tracheostomy
Congenital heart defect; Mechanical ventilation; Outcomes; Pediatrics; Thoracic surgery; Tracheostomy; CHD
Ortmann LA, Manimtim WM, Lachica CI. Outcomes of Tracheostomy in Children Requiring Surgery for Congenital Heart Disease. Pediatr Cardiol. 2017;38(2):296-301. doi:10.1007/s00246-016-1512-6