Time-dependent decannulation rate after pediatric tracheostomy

Background Diagnosis, age, and maturity at birth and the indication for tracheostomy affect the likelihood of decannulation in children and neonates after tracheostomy.

Material and Methods The medical records of 106 children and neonates (age 0–18 years) tracheostomized between January 1, 1999, and January 1, 2019, were reviewed, and questionnaires were sent out. The indication for tracheostomy was divided into three different groups: unsafe airway, long-term respiratory dependence, or bronchopulmonary toilet. Time-dependent decannulation rates were estimated according to the Kaplan-Meier method.

Results 40 patients (37.7%) were successfully decannulated. The time-dependent decannulation rate after two years was 28.3% for patients tracheostomized for an unsafe airway, 42.4% for patients with long-term respiratory dependence, and 41.7% for patients needing a bronchopulmonary toilet. After two years, patients aged 0–12 months at the time of tracheostomy were decannulated in 13.1% of cases, 1–5-year-olds in 35.3% of cases, 6–10-year-olds in 70.0% of cases, and 11–18-year-olds in 66.6% of cases. Premature infants were decannulated less frequently (16.2% after two years) compared with mature infants (40.1%).

Conclusions Factors indicating problems with decannulation are an unsafe airway, a young age at the time of tracheostomy, and prematurity.

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Publication History

Article published online:
10 June 2020