Timing of Tracheostomy, Weaning from Mechanical Ventilation and Duration of Hospitalization among a Sample of Pediatric Patients

  • Jose Brian A. Ferrolino Department of Otorhinolaryngology Philippine General Hospital University of the Philippines Manila https://orcid.org/0000-0003-1238-0103
  • José Florencio F. Lapena Jr. Department of Otorhinolaryngology College of Medicine – Philippine General Hospital University of the Philippines Manila https://orcid.org/0000-0002-5794-1878
  • Ryner Jose D. Carrillo Department of Otorhinolaryngology Philippine General Hospital University of the Philippines Manila; Department of Anatomy College of Medicine University of the Philippines Manila
Keywords: tracheotomy, pediatric, mechanical ventilation, hospitalization

Abstract

Objective: To determine if there is a difference in the duration of mechanical ventilation and hospitalization between patients who underwent early compared to late tracheostomy.

Methods:

     Design:                Causal-Comparative (ex post facto) Chart Review

     Setting:                Tertiary National University Hospital

     Participants:                   Records of 68 pediatric patients who underwent elective tracheostomy from January 1, 2013 to June 30, 2018 were considered for inclusion. Patients were excluded if invasive mechanical ventilation was not done prior to tracheostomy, if they underwent emergency tracheostomy or had incomplete records. Selected patients were categorized in the early tracheostomy group if the procedure was performed within 14 days of mechanical ventilation and late tracheostomy group if performed beyond 14 days. Early post-tracheostomy weaning from mechanical ventilation was defined as less than 7 days from time of tracheostomy.

Results: A total of 21 patients were included, 6 in the early tracheostomy group and 15 in the late tracheostomy group. Although early tracheostomy did not show significant association with shortened post-tracheostomy duration of mechanical ventilation (O.R. 6; C.I. 0.276 to 130.322; p = .476), two-sample t-tests showed the early tracheostomy group had a significantly shorter mean duration of mechanical ventilation and hospitalization compared to the late tracheostomy group (13.17 vs. 54.13 days, p = .0012; 21.17 vs. 66.67 days, p = .0032).

Conclusion: Although early tracheostomy does not shorten post-tracheostomy mechanical ventilation support, there is a significant difference in the duration of mechanical ventilation and hospitalization between early and late tracheostomy groups and this may suggest potential benefits of performing tracheostomy earlier in children.

 

Keywords: tracheotomy; pediatric; mechanical ventilation; hospitalization

 

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Published
2019-12-02
How to Cite
1.
Ferrolino JB, Lapeña JF, Carrillo RJ. Timing of Tracheostomy, Weaning from Mechanical Ventilation and Duration of Hospitalization among a Sample of Pediatric Patients. Philipp J Otolaryngol Head Neck Surg [Internet]. 2019Dec.2 [cited 2019Dec.10];34(2):16-9. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1097