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Tracheotomy and decannulation rates in a level 3 neonatal intensive care unit: a 12-year study.

AbstractOBJECTIVE:
The objective of this study was to determine the rates of tracheotomy tube placement and subsequent decannulation in all admissions to a single-site, tertiary newborn intensive care unit (NICU).
METHODS:
Records from total admissions to a tertiary single-site NICU between January 1, 1991, and December 31, 2002, were retrospectively analyzed. Long-term medical follow-up for this cohort included data through September 1, 2003. All patients were analyzed for occurrence of tracheotomy tube placement and decannulation, airway procedures, and comorbidities.
RESULTS:
There were 10,428 total NICU admissions during the 12-year study period. Seventy-eight (0.7%) of these patients underwent tracheotomy tube placement. Sixty-six of these 78 (85%) infants survived. None of the 12 deaths were related to tracheotomy tube placement. The most common indications for tracheotomy tube placement were subglottic stenosis (32%), chronic lung disease (28%), craniofacial abnormality (14%), chronic ventilator dependency (11%), and a neurologic disorder (8%). Decannulation was achieved in 41 of 66 (62%) survivors. Patients who failed decannulation had a major neurologic disorder, underlying pulmonary disorder, or both.
CONCLUSION:
A baseline tracheotomy tube placement rate of 0.7% was observed in this single-site tertiary NICU setting. Decannulation was accomplished early in life in two thirds of the surviving infants. Those infants failing decannulation had either severe underlying pulmonary or neurologic disorders.
AuthorsJames D Sidman, Abraham Jaguan, Robert J Couser
JournalThe Laryngoscope (Laryngoscope) Vol. 116 Issue 1 Pg. 136-9 (Jan 2006) ISSN: 0023-852X [Print] United States
PMID16481826 (Publication Type: Journal Article)
Topics
  • Airway Obstruction (diagnosis, epidemiology, surgery)
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant, Newborn
  • Intensive Care Units, Neonatal (statistics & numerical data)
  • Intubation, Intratracheal (methods, statistics & numerical data)
  • Male
  • Medical Records (statistics & numerical data)
  • Minnesota
  • Respiration, Artificial (statistics & numerical data)
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Tracheotomy (methods, statistics & numerical data)
  • Treatment Outcome

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