Tracheostomy Complications and Efficiency Tracheostomy De- Cannulation Protocol

Abstract

Background: Tracheostomy tube is required in approximately 10% of patients receiving mechanical ventilation. The presence of tracheostomy tube cause complications, include tracheal stenosis, bleeding, infection, aspiration pneumonia, and fistula.

Objective:  tracheostomy complication and efficiency of  Tracheostomy  de-cannulation protocol  at pediatric intensive care units.

Methods:  retrospective -cohort study including children admitted in pediatric Intensive Care Unit , and had a tracheostomy after long duration of mechanichal ventilation, we studied complication of tracheostomy  with application of tracheostomy de-cannulation protocol after applied special protocol.

Findings: The study included 32 patients 65% male and 35% female. Average ages is 7,8 years. 78.2% of patients had tracheostomy due to neurological reasons while 21.2% due to respiratory reasons. The capping succeeded from the first trial in 20 patients 62% and in 6 patients from the second trial 18.7%. the duration that needed for capping was between 48 hours as minimum and  2 weeks as maximum. The decanulation  failed in 3 cases 9.3% from 32 patients. In the study of complication we found early complication were localized infections in 21.8%, pneumothorax in 6.2%,atelectasis in 25%. While the late complications were trachea stenosis 6.2%, hypophonia or aphonia in 31.2%  and bronchoesophageal fistula in 3.1%.  

Conclusion: effectiveness of the tracheostomy  de-cannulation protocol in increasing the rate of de-cannulation success, decreasing the rate of complications and reducing the period of tracheostomy.