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

Pediatrik Trakeostomi: 25 Vakanın Endikasyon ve Komplikasyon AnaliziPediatric Tracheotomy: Indication and Complication Analysis of 25 Cases

Amaç: Bu çalışmada daha önceden farklı nedenlerle trakeotomi uygulanmış 25 pediatrik hasta ele alındı. Endikasyonlar, komplikasyonlar ve elde edilen sonuçlar değerlendirildi. Çocuklarda trakeotomi uygulaması hakkında deneyimlerimizi paylaşmayı ve özellikle kulak burun boğaz ve pediatri kliniklerinde görev yapan hekimlere bu konu ile ilgili fikir vermeyi amaçladık.Gereç ve Yöntem: 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 ilişkili hastalıklar (n=2, 3.8%) uzun entübasyona neden olan durumlardı. Trakeotomi 6 (%24) çocuk hastada üst hava yolu 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 ortalama dekanülasyon 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 güncel bir bilgi sunmayı hedefledik. Aim: In this study 25 pediatric patients that underwent tracheotomy due to different reasons were evaluated and 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 to clinicians especially those working in Otolaryngology and Pediatric departments.Materials and Methods: Twenty five children patients (n=17, 68% boys; n=8, 32% girls) applied tracheotomy between 2006 and 2015 were analyzed retrospectively. The indications of tracheotomy, early and late complications, the time of decannulation and results after tracheotomy were recorded.Findings: Prolonged intubation was the most common indication (n=19, 76%) for tracheotomy. Respiratory failure (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. Tracheotomy was 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% and 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 of patients died after tracheotomy was 12 (48%).Conclusion: We tried to detect the indications, complications due to tracheotomy and the results after the procedure in children and aimed to give an up-to-date information.

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