Department of ENT-HNS, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2023 Nov 1;61(267):852-855. doi: 10.31729/jnma.8323.
Tracheostomy is commonly performed for upper airway obstruction, prolonged mechanical ventilation and tracheo-bronchial toileting. Pediatric tracheostomy differs from adult tracheostomy in terms of surgical procedure, post-operative care and recovery. The tracheostomized patients may either be decannulated, discharged with tube-in-situ or the patient may expire. The aim of this study was to find out the prevalence of tracheostomy in patients admitted to the Pediatric intensive care unit of a tertiary care centre.
A descriptive cross-sectional study was performed among children admitted to the Pediatric intensive care unit of a tertiary care centre from 1 May 2017 to 31 August 2022 after obtaining ethical approval from the Institutional Review Committee. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval.
Among 1472 patients, tracheostomy was done in 65 (4.41%) (3.37-5.47, 95% Confidence Interval). A total of 33 (50.76%) underwent tracheostomy for prolonged ventilation whereas 32 (49.23%) were tracheostomized for airway obstruction. Among them, 41 (63.07%) patients were successfully decannulated, 9 (13.84%) were discharged with tracheostomy tubes in situ whereas 15 (23.07%) patients deceased. The most common complication was tracheostomy tube blockage reported in 5 (7.69%).
The prevalence of tracheostomy among the children of the pediatric intensive care unit was found to be lower than in other studies.
mechanical ventilation; complication; pediatric; tracheostomy.
气管切开术常用于治疗上气道阻塞、长时间机械通气和气管支气管灌洗。儿科气管切开术在手术过程、术后护理和恢复方面与成人气管切开术不同。气管切开的患者可能会拔管、带管出院，也可能会死亡。本研究旨在了解三级护理中心儿科重症监护病房患者气管切开的发生率。
本研究为描述性横断面研究，于 2017 年 5 月 1 日至 2022 年 8 月 31 日期间，在获得机构审查委员会的伦理批准后，在三级护理中心的儿科重症监护病房对儿童进行研究。采用便利抽样法。点估计值在 95%置信区间内计算。
在 1472 名患者中，有 65 名（4.41%）（3.37-5.47，95%置信区间）进行了气管切开术。共有 33 名（50.76%）患者因长时间通气而行气管切开术，32 名（49.23%）患者因气道阻塞而行气管切开术。其中，41 名（63.07%）患者成功拔管，9 名（13.84%）患者带管出院，15 名（23.07%）患者死亡。最常见的并发症是气管切开管堵塞，有 5 名（7.69%）患者报告了该并发症。
与其他研究相比，儿科重症监护病房儿童的气管切开发生率较低。
机械通气；并发症；儿科；气管切开术。
