Indications, complications, and surgical techniques for pediatric tracheostomies—An update☆
Section snippets
Materials and methods
We evaluated the international literature for pediatric tracheostomy since 1971, using 49 publications for pediatric tracheostomy in general and 38 studies regarding indications and complications of tracheostomy in children. A literature search was done with the data banks of MEDLINE and DIMDI; search terms were pediatric, tracheotomy, tracheostomy, indication, complication, and outcome. Each publication was evaluated according to its age spread, indications, complications and—if
Definition of the term child in regard to tracheostomy
The definition of child according to tracheostomy includes patients less than 3 years old1 to younger than 19 years of age.2 Some investigators have researched tracheostomy in premature babies and newborns only,3, 4, 5, 6 whereas others dealt exclusively with tracheostomy in infants. The age limit in our study was 6 years, which was determined by consideration of the Law of Hagen-Poiseuille: v = r4/8l × (p1-p2) × t (V = volume, r = radius, l = length, p = pressure, and t = time), which states
Discussion
The aim of this study was to establish data regarding indications, techniques, and complications of pediatric tracheostomy, which would reflect the current state of science. Therefore, the international literature from the past decades was analyzed and compared with our own experience with 25 tracheostomies performed in children younger than 6 years. Literature research proved to be very difficult caused by the heterogeneity of the different studies. Comparability was limited by differences in
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Address reprint requests to Bernd Kremer, MD, PhD, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Maastricht, PO Box 5800, NL-6202 AZ Maastricht, The Netherlands.