Complications of Neonatal Tracheostomy: A 5-Year Review

Abstract

OBJECTIVE: Study the complication rate of tracheostomy in premature infants and identify contributing factors. SETTING: Two university-based tertiary care children's hospitals. METHODS: The charts of 55 neonates who underwent tracheostomy between January 1997 and December 2002 were reviewed. Group 1 included 32 infants born weighing < 1000 grams. Group 2 included 23 infants born weighing ≥ 1000 grams. RESULTS: Group 1 infants had a higher incidence of comorbidities related to prematurity. Thirty-eight infants underwent tracheostomy due to ventilatory dependence, 13 for airway obstruction, and 4 for neurologic debilitation. Sixteen infants (29%) had a complication related to tracheostomy. There was no tracheostomy-related mortality. CONCLUSIONS: Tracheostomy in the preterm infant has the potential for significant morbidity. Meticulous technique, surgeon experience and specialized care may play a role in reducing the complication rate. Complications are usually minor and do not require additional surgical intervention. EBM rating: C.