Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience
Introduction Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking. Methods An 8‐year retrospect...
Gespeichert in:
| Veröffentlicht in: | Congenital heart disease 2015-01, Vol.10 (1), p.E25-E29 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | E29 |
|---|---|
| container_issue | 1 |
| container_start_page | E25 |
| container_title | Congenital heart disease |
| container_volume | 10 |
| creator | Costello, John P. Emerson, Dominic A. Shu, Michael K. Peer, Syed M. Zurakowski, David Reilly, Brian K. Klugman, Darren Jonas, Richard A. Nath, Dilip S. |
| description | Introduction
Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking.
Methods
An 8‐year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients were evaluated with regard to the timing of tracheostomy and mortality.
Results
The overall study mortality was 24%. The median duration of intubation prior to tracheostomy was 60 days (interquartile range: 19–90 days); there was no difference in the average time between intubation and tracheostomy for survivors compared with nonsurvivors (51 vs. 73 days, P = .37). No difference was observed in the overall duration of positive pressure ventilation when tracheostomy was performed within 30 days of intubation compared with greater than 30 days following intubation (481 vs. 451 days, P = .88). Overall, 18% of patients were successfully weaned from the ventilator after a median duration of positive pressure ventilation of 212 days.
Conclusion
The timing of tracheostomy placement may be an important factor in clinical outcomes for pediatric patients with persistent dependence on mechanical ventilatory support following congenital heart surgery. A larger, multi‐institution study may help further elucidate our observed clinical findings in this patient population. |
| doi_str_mv | 10.1111/chd.12192 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1652459405</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3579570211</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4272-b14351832592dca3478593cdbebd56a8f74f60ec335e74117dbc855aaad1be5a3</originalsourceid><addsrcrecordid>eNpdkclOwzAQhi0EYj_wAigSFy5pvcY2N1SWIlWAxHqzHGdaAklc7ETQtyelwIG5zEjz_aOZ-RE6IHhA-hi6l2JAKNF0DW0TyWWKFWbrv7XUz1toJ8ZXjHnGpNpEW5QrrYjE2-jxpmudryEmfprcB-tewMfW14vkwleV_yibWTLyzQyasrVVMgYb2uSuCzMIi5PkdNlroZ77YMMiOf-cQyihcbCHNqa2irD_k3fRw8X5_WicTm4ur0ank9RxKmmaE84EUYwKTQtnGZdKaOaKHPJCZFZNJZ9mGBxjAiQnRBa5U0JYawuSg7BsFx2v5s6Df-8gtqYuo4Oqsg34LhqSCcqF5lj06NE_9NV3oem3W1KESkao7qnDH6rLayjMPJR1f5r5_VgPDFfAR1nB4q9PsFlaYXorzLcVZjQ--y56RbpSlLGFzz-FDW8mk0wK83R9aW4nVN_qxzuj2BfiuIm8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1651273129</pqid></control><display><type>article</type><title>Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><creator>Costello, John P. ; Emerson, Dominic A. ; Shu, Michael K. ; Peer, Syed M. ; Zurakowski, David ; Reilly, Brian K. ; Klugman, Darren ; Jonas, Richard A. ; Nath, Dilip S.</creator><creatorcontrib>Costello, John P. ; Emerson, Dominic A. ; Shu, Michael K. ; Peer, Syed M. ; Zurakowski, David ; Reilly, Brian K. ; Klugman, Darren ; Jonas, Richard A. ; Nath, Dilip S.</creatorcontrib><description>Introduction
Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking.
Methods
An 8‐year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients were evaluated with regard to the timing of tracheostomy and mortality.
Results
The overall study mortality was 24%. The median duration of intubation prior to tracheostomy was 60 days (interquartile range: 19–90 days); there was no difference in the average time between intubation and tracheostomy for survivors compared with nonsurvivors (51 vs. 73 days, P = .37). No difference was observed in the overall duration of positive pressure ventilation when tracheostomy was performed within 30 days of intubation compared with greater than 30 days following intubation (481 vs. 451 days, P = .88). Overall, 18% of patients were successfully weaned from the ventilator after a median duration of positive pressure ventilation of 212 days.
Conclusion
The timing of tracheostomy placement may be an important factor in clinical outcomes for pediatric patients with persistent dependence on mechanical ventilatory support following congenital heart surgery. A larger, multi‐institution study may help further elucidate our observed clinical findings in this patient population.</description><identifier>ISSN: 1747-079X</identifier><identifier>EISSN: 1747-0803</identifier><identifier>DOI: 10.1111/chd.12192</identifier><identifier>PMID: 24898170</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Age Factors ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - mortality ; Congenital Heart Surgery ; Critical Care ; Female ; Heart ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - mortality ; Heart Defects, Congenital - surgery ; Heart surgery ; Hospital Mortality ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Intubation ; Intubation, Intratracheal ; Male ; Mechanical Ventilation ; Mortality ; Ostomy ; Positive-Pressure Respiration ; Respiratory Insufficiency - diagnosis ; Respiratory Insufficiency - etiology ; Respiratory Insufficiency - mortality ; Respiratory Insufficiency - therapy ; Retrospective Studies ; Risk Factors ; Time Factors ; Time-to-Treatment ; Tracheostomy ; Tracheostomy - adverse effects ; Tracheostomy - mortality ; Treatment Outcome ; Ventilation</subject><ispartof>Congenital heart disease, 2015-01, Vol.10 (1), p.E25-E29</ispartof><rights>2014 Wiley Periodicals, Inc</rights><rights>2014 Wiley Periodicals, Inc.</rights><rights>Copyright © 2015 Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4272-b14351832592dca3478593cdbebd56a8f74f60ec335e74117dbc855aaad1be5a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fchd.12192$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fchd.12192$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24898170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Costello, John P.</creatorcontrib><creatorcontrib>Emerson, Dominic A.</creatorcontrib><creatorcontrib>Shu, Michael K.</creatorcontrib><creatorcontrib>Peer, Syed M.</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Reilly, Brian K.</creatorcontrib><creatorcontrib>Klugman, Darren</creatorcontrib><creatorcontrib>Jonas, Richard A.</creatorcontrib><creatorcontrib>Nath, Dilip S.</creatorcontrib><title>Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience</title><title>Congenital heart disease</title><addtitle>Congenit Heart Dis</addtitle><description>Introduction
Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking.
Methods
An 8‐year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients were evaluated with regard to the timing of tracheostomy and mortality.
Results
The overall study mortality was 24%. The median duration of intubation prior to tracheostomy was 60 days (interquartile range: 19–90 days); there was no difference in the average time between intubation and tracheostomy for survivors compared with nonsurvivors (51 vs. 73 days, P = .37). No difference was observed in the overall duration of positive pressure ventilation when tracheostomy was performed within 30 days of intubation compared with greater than 30 days following intubation (481 vs. 451 days, P = .88). Overall, 18% of patients were successfully weaned from the ventilator after a median duration of positive pressure ventilation of 212 days.
Conclusion
The timing of tracheostomy placement may be an important factor in clinical outcomes for pediatric patients with persistent dependence on mechanical ventilatory support following congenital heart surgery. A larger, multi‐institution study may help further elucidate our observed clinical findings in this patient population.</description><subject>Age Factors</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Congenital Heart Surgery</subject><subject>Critical Care</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Defects, Congenital - diagnosis</subject><subject>Heart Defects, Congenital - mortality</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Heart surgery</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intubation</subject><subject>Intubation, Intratracheal</subject><subject>Male</subject><subject>Mechanical Ventilation</subject><subject>Mortality</subject><subject>Ostomy</subject><subject>Positive-Pressure Respiration</subject><subject>Respiratory Insufficiency - diagnosis</subject><subject>Respiratory Insufficiency - etiology</subject><subject>Respiratory Insufficiency - mortality</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Time-to-Treatment</subject><subject>Tracheostomy</subject><subject>Tracheostomy - adverse effects</subject><subject>Tracheostomy - mortality</subject><subject>Treatment Outcome</subject><subject>Ventilation</subject><issn>1747-079X</issn><issn>1747-0803</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkclOwzAQhi0EYj_wAigSFy5pvcY2N1SWIlWAxHqzHGdaAklc7ETQtyelwIG5zEjz_aOZ-RE6IHhA-hi6l2JAKNF0DW0TyWWKFWbrv7XUz1toJ8ZXjHnGpNpEW5QrrYjE2-jxpmudryEmfprcB-tewMfW14vkwleV_yibWTLyzQyasrVVMgYb2uSuCzMIi5PkdNlroZ77YMMiOf-cQyihcbCHNqa2irD_k3fRw8X5_WicTm4ur0ank9RxKmmaE84EUYwKTQtnGZdKaOaKHPJCZFZNJZ9mGBxjAiQnRBa5U0JYawuSg7BsFx2v5s6Df-8gtqYuo4Oqsg34LhqSCcqF5lj06NE_9NV3oem3W1KESkao7qnDH6rLayjMPJR1f5r5_VgPDFfAR1nB4q9PsFlaYXorzLcVZjQ--y56RbpSlLGFzz-FDW8mk0wK83R9aW4nVN_qxzuj2BfiuIm8</recordid><startdate>201501</startdate><enddate>201501</enddate><creator>Costello, John P.</creator><creator>Emerson, Dominic A.</creator><creator>Shu, Michael K.</creator><creator>Peer, Syed M.</creator><creator>Zurakowski, David</creator><creator>Reilly, Brian K.</creator><creator>Klugman, Darren</creator><creator>Jonas, Richard A.</creator><creator>Nath, Dilip S.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>JQ2</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201501</creationdate><title>Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience</title><author>Costello, John P. ; Emerson, Dominic A. ; Shu, Michael K. ; Peer, Syed M. ; Zurakowski, David ; Reilly, Brian K. ; Klugman, Darren ; Jonas, Richard A. ; Nath, Dilip S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4272-b14351832592dca3478593cdbebd56a8f74f60ec335e74117dbc855aaad1be5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Age Factors</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Congenital Heart Surgery</topic><topic>Critical Care</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Defects, Congenital - diagnosis</topic><topic>Heart Defects, Congenital - mortality</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Heart surgery</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intubation</topic><topic>Intubation, Intratracheal</topic><topic>Male</topic><topic>Mechanical Ventilation</topic><topic>Mortality</topic><topic>Ostomy</topic><topic>Positive-Pressure Respiration</topic><topic>Respiratory Insufficiency - diagnosis</topic><topic>Respiratory Insufficiency - etiology</topic><topic>Respiratory Insufficiency - mortality</topic><topic>Respiratory Insufficiency - therapy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Time-to-Treatment</topic><topic>Tracheostomy</topic><topic>Tracheostomy - adverse effects</topic><topic>Tracheostomy - mortality</topic><topic>Treatment Outcome</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Costello, John P.</creatorcontrib><creatorcontrib>Emerson, Dominic A.</creatorcontrib><creatorcontrib>Shu, Michael K.</creatorcontrib><creatorcontrib>Peer, Syed M.</creatorcontrib><creatorcontrib>Zurakowski, David</creatorcontrib><creatorcontrib>Reilly, Brian K.</creatorcontrib><creatorcontrib>Klugman, Darren</creatorcontrib><creatorcontrib>Jonas, Richard A.</creatorcontrib><creatorcontrib>Nath, Dilip S.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Congenital heart disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Costello, John P.</au><au>Emerson, Dominic A.</au><au>Shu, Michael K.</au><au>Peer, Syed M.</au><au>Zurakowski, David</au><au>Reilly, Brian K.</au><au>Klugman, Darren</au><au>Jonas, Richard A.</au><au>Nath, Dilip S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience</atitle><jtitle>Congenital heart disease</jtitle><addtitle>Congenit Heart Dis</addtitle><date>2015-01</date><risdate>2015</risdate><volume>10</volume><issue>1</issue><spage>E25</spage><epage>E29</epage><pages>E25-E29</pages><issn>1747-079X</issn><eissn>1747-0803</eissn><abstract>Introduction
Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking.
Methods
An 8‐year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients were evaluated with regard to the timing of tracheostomy and mortality.
Results
The overall study mortality was 24%. The median duration of intubation prior to tracheostomy was 60 days (interquartile range: 19–90 days); there was no difference in the average time between intubation and tracheostomy for survivors compared with nonsurvivors (51 vs. 73 days, P = .37). No difference was observed in the overall duration of positive pressure ventilation when tracheostomy was performed within 30 days of intubation compared with greater than 30 days following intubation (481 vs. 451 days, P = .88). Overall, 18% of patients were successfully weaned from the ventilator after a median duration of positive pressure ventilation of 212 days.
Conclusion
The timing of tracheostomy placement may be an important factor in clinical outcomes for pediatric patients with persistent dependence on mechanical ventilatory support following congenital heart surgery. A larger, multi‐institution study may help further elucidate our observed clinical findings in this patient population.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24898170</pmid><doi>10.1111/chd.12192</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1747-079X |
| ispartof | Congenital heart disease, 2015-01, Vol.10 (1), p.E25-E29 |
| issn | 1747-079X 1747-0803 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1652459405 |
| source | Wiley-Blackwell Journals; MEDLINE |
| subjects | Age Factors Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - mortality Congenital Heart Surgery Critical Care Female Heart Heart Defects, Congenital - diagnosis Heart Defects, Congenital - mortality Heart Defects, Congenital - surgery Heart surgery Hospital Mortality Hospitals Humans Infant Infant, Newborn Intubation Intubation, Intratracheal Male Mechanical Ventilation Mortality Ostomy Positive-Pressure Respiration Respiratory Insufficiency - diagnosis Respiratory Insufficiency - etiology Respiratory Insufficiency - mortality Respiratory Insufficiency - therapy Retrospective Studies Risk Factors Time Factors Time-to-Treatment Tracheostomy Tracheostomy - adverse effects Tracheostomy - mortality Treatment Outcome Ventilation |
| title | Outcomes of Tracheostomy Following Congenital Heart Surgery: A Contemporary Experience |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T17%3A03%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20of%20Tracheostomy%20Following%20Congenital%20Heart%20Surgery:%20A%20Contemporary%20Experience&rft.jtitle=Congenital%20heart%20disease&rft.au=Costello,%20John%20P.&rft.date=2015-01&rft.volume=10&rft.issue=1&rft.spage=E25&rft.epage=E29&rft.pages=E25-E29&rft.issn=1747-079X&rft.eissn=1747-0803&rft_id=info:doi/10.1111/chd.12192&rft_dat=%3Cproquest_pubme%3E3579570211%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1651273129&rft_id=info:pmid/24898170&rfr_iscdi=true |