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Perioperative and Long‐Term Outcomes in Infants Undergoing a Tracheostomy from a Neonatal Intensive Care Unit

Lambert, Elton M. ; Ramaswamy, Uma ; Gowda, Sharada H. ; Spielberg, David R. ; Hagan, Joseph L. ; Xiao, Emily ; Liu, Sean ; Villafranco, Natalie ; Raynor, Tiffany ; Baijal, Rahul G.

The Laryngoscope, 2024-04, Vol.134 (4), p.1945-1954 [Periódico revisado por pares]

Hoboken, USA: John Wiley & Sons, Inc

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  • Título:
    Perioperative and Long‐Term Outcomes in Infants Undergoing a Tracheostomy from a Neonatal Intensive Care Unit
  • Autor: Lambert, Elton M. ; Ramaswamy, Uma ; Gowda, Sharada H. ; Spielberg, David R. ; Hagan, Joseph L. ; Xiao, Emily ; Liu, Sean ; Villafranco, Natalie ; Raynor, Tiffany ; Baijal, Rahul G.
  • Assuntos: Child ; Heart Arrest ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; neonate ; perioperative complications ; Retrospective Studies ; tracheostomy ; Tracheostomy - adverse effects ; Tracheostomy - methods
  • É parte de: The Laryngoscope, 2024-04, Vol.134 (4), p.1945-1954
  • Notas: The authors have no funding, financial relationships, or conflicts of interest to disclose.
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  • Descrição: Objective The purpose of this study was to identify risk factors for perioperative complications and long‐term morbidity in infants from the neonatal intensive care unit (NICU) presenting for a tracheostomy. Methods This single‐center retrospective cohort study included infants in the NICU presenting for a tracheostomy from August 2011 to December 2019. Primary outcomes were categorized as either a perioperative complication or long‐term morbidity. A severe perioperative complication was defined as having either (1) an intraoperative cardiopulmonary arrest, (2) an intraoperative death, (3) a postoperative cardiopulmonary arrest within 30 days of the procedure, or (4) a postoperative death within 30 days of the procedure. Long‐term morbidities included (1) the need for gastrostomy tube placement within the tracheostomy hospitalization and (2) the need for diuretic therapy, pulmonary hypertensive therapy, oxygen, or mechanical ventilation at 12 and 24 months following the tracheostomy. Results One‐hundred eighty‐three children underwent a tracheostomy. The mean age at tracheostomy was 16.9 weeks while the mean post‐conceptual age at tracheostomy was 49.7 weeks. The incidence of severe perioperative complications was 4.4% (n = 8) with the number of pulmonary hypertension medication classes preoperatively (OR: 3.64, 95% CI: (1.44–8.94), p = 0.005) as a significant risk factor. Approximately 81% of children additionally had a gastrostomy tube placed at the time of the tracheostomy, and 62% were ventilator‐dependent 2 years following their tracheostomy. Conclusion Our study provides critical perioperative complications and long‐term morbidity data to neonatologists, pediatricians, surgeons, anesthesiologists, and families in the expected course of infants from the NICU presenting for a tracheostomy. Level of Evidence 3 Laryngoscope, 134:1945–1954, 2024 The purpose of this study was to identify risk factors for perioperative complications and long‐term morbidity in infants from the neonatal intensive care unit (NICU) presenting for a tracheostomy. This single‐center retrospective cohort study found an incidence of severe perioperative complications of 4.4%, including perioperative cardiac arrest and death, with the number of pulmonary hypertension medication classes preoperatively as a significant risk factor. Furthermore, approximately 81% of patients had a gastrostomy tube placement at the time of the tracheostomy and 62% of patients were ventilator dependent 2 years following the tracheostomy. Our study provides critical perioperative and long‐term data to neonatologists, pediatricians, surgeons, anesthesiologists, and families about the expected course of infants from the NICU presenting for a tracheostomy.
  • Editor: Hoboken, USA: John Wiley & Sons, Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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