Factors associated with successful decannulation in pediatric tracheostomy patients

Abstract

Objectives: To investigate the outcome of pediatric tracheostomy and identify predictive factors for successful decannulation.

Methods: We performed a retrospective chart review of a series of 42 consecutive patients of less than 24 months of age who underwent a tracheostomy between 2012 and 2015.

Results: Successful decannulation was achieved in 11 patients (26%). Thirty-one patients (74%) remained tracheostomy-dependent. Of the 11 patients who were successfully decannulated, 10 (91%) had only structural disorders and nine (82%) were able to walk unassisted; importantly, nine (82%) were able to swallow following decannulation. In contrast, of the 31 patients who did not tolerate decannulation, 21 (68%) had functional disorders and 18 (58%) were unable to walk unassisted; 20 (65%) of the tracheostomy-dependent patients were unable to swallow after undergoing surgery.

Conclusion: Following pediatric tracheostomy procedures, patients with solely structural disorders were significantly more likely to be successfully decannulated compared to patients with functional disorders. Furthermore, the capacity to walk unassisted and swallow after surgery is associated with positive outcomes for decannulation. Our results suggest that an objective evaluation of the ability to walk unassisted, and to ingest food, may be useful for predicting the outcome and effects of tracheostomy procedures and decannulation in children.

Chinese abstract

目的: 调查儿科气管切开术的结果, 并确定成功拔管的预测因素。

方法: 我们对2012年至2015年间接受气管切开术的42例年龄不到24个月的一系列连续患者进行了回顾性图表回顾。

结果: 11例患者 (26%) 获得成功拔管。 31例 (74%) 患者仍旧依靠气管切开术。在11例成功拔管的患者中, 10例 (91%) 仅有结构性障碍, 9例 (82%) 能够无助行走;重要的是, 九例患者 (82%) 在拔管之后能够吞咽。相比之下, 在31例不能耐受拔管的患者中, 21例 (68%) 有功能障碍, 18例 (58%) 无法无助行走; 气管切开术患者中有20例 (65%) 在手术后无法吞咽。

结论: 在儿科气管切开手术后, 单纯结构性疾病的患者与功能障碍患者相比, 更有可能成功地取得拔管。此外, 手术后无助行走和吞咽的能力与拔管的正面结果相关。我们的研究结果表明, 对无助行走能力和摄入食物的能力进行客观评估可能有助于预测儿童气管切开术和儿童拔管的结果和作用。

Keywords:

• Tracheostomy
• decannulation
• pediatric tracheostomy
• airway

Disclosure statement

No potential conflict of interest was reported by the author(s).