Mansur DOĞAN, Ahmet Sami GÜVEN, Mehmet ARPACIK, Fevzi CAN, Kerem POLAT, İsmail Önder UYSAL, Salim YÜCE

PEDİATRİK TRAKEOSTOMİ: 25 VAKANIN ENDİKASYON VE KOMPLİKASYON ANALİZİ

Amaç: Bu çalışmada daha önceden farklı nedenlerle trakeotomi uygulanmış 25 pediatrik hasta ele alındı.Endikasyonlar, komplikasyonlar ve elde edilen sonuçlar değerlendirildi. Çocuklarda trakeotomi uygulamasıhakkında deneyimlerimizi paylaşmayı ve özellikle kulak burun boğaz ve pediatri kliniklerinde görev yapan hekimlere bu konu ile ilgili fikir vermeyi amaçladık. Gereç ve Yöntemler: 2006 ve 2015 yılları arasında trakeotomi uygulanan 25 çocuk hasta (n=17, 68% erkek;n=8, 32% kız) retrospektif olarak değerlendirildi. Trakeotomi endikasyonları, erken ve geç komplikasyonlar,dekanülasyon süresi ve trakeotomi sonrası akıbetleri kaydedildi. Bulgular: En sık trakeotomi endikasyonu uzun entübasyon süresi idi (n=19, 76%). Solunum yetmezliği (n=9,36%), nöromusküler hastalıklar (n=4, 16%), büyük cerrahi sonrası süreç (n=3, 12%) ve enfeksiyon / sepsis ilişkilihastalıklar (n=2, 3.8%) uzun entübasyona neden olan durumlardı. Trakeotomi 6 (%24) çocuk hastada üst havayolu obstrüksiyonu nedeni ile uygulandı. Ortalama entübasyon süresi 18.7±15 gün idi. Erken ve geç komplikasyon oranları her ikisi de %8 idi. Dekanülasyon başarısına 8 (%32) çocukta ulaşıldı. Trakeotomi sonrası ortalamadekanülasyon süresi 29.4±20.8 gün idi. Trakeotomi sonrası hayatını kaybeden hasta sayısı 12 (48%) idi.Sonuç: Biz çocuklarda trakeotomi endikasyonları, komplikasyonları ve sonuçlarını ele alarak bu konuda güncelbir bilgi sunmayı hedefledik.

Pediatric Tracheotomy: Indication and Complication Analysis of 25 Cases

Aim: In this study 25 pediatric patients that underwent tracheotomy due to different reasons were evaluatedand the indications, complications due to tracheotomy and the results after the procedure were detected.We wanted to share our experience about the use of tracheotomy in children and aimed to give an idea toclinicians especially those working in Otolaryngology and Pediatric departments.Material and Methods: Twenty five children (n=17, 68% boys; n=8, 32% girls) applied tracheotomy between2006 and 2015 were analyzed retrospectively. The indications of tracheotomy, early and late complications,the time of decannulation and results after tracheotomy were recorded. Results: Prolonged intubation was the most common indication (n=19, 76%) for tracheotomy. Respiratoryfailure (n=9, 36%), neuromuscular diseases (n=4, 16%), postoperative period following major surgery (n=3,12%) and infection/sepsis related diseases (n=2, 3.8%) were the causes of prolonged intubation. Tracheotomywas performed for upper airway obstruction in 6 (24%) children. The mean intubation time was 18.7±15 days.Early and late complication rates were 8% respectively. Decannulation success was observed in 8 children(32%). Mean decannulation time after tracheotomy was 29.4±20.8 days in the patients. The number ofpatients died after tracheotomy was 12 (48%). Conclusion: We evaluated the indications, the complications due to tracheotomy and the results after theprocedure in children and aimed to give an up-to-date information.

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