Tracheostomy in the Young Pediatric Burn Patient

OBJECTIVE To evaluate the incidence of complications in comparison with the benefits of tracheostomy in young pediatric burn patients (newborn to 3 years old). DESIGN Retrospective survey. SETTING Tertiary care burn center. PATIENTS A total of 1549 consecutive pediatric burn patients, of whom 180 were intubated. INTERVENTIONS Tracheostomy was performed in 76 children. MAIN OUTCOME MEASURES Duration of mechanical ventilation, mortality, respiratory complications, airway complications, and condition of the airway at discharge from the hospital. RESULTS Seventy-six patients required tracheostomy. Their mean burn size was 34% total body surface area and mean length of stay in the hospital was 56 days. There were no perioperative complications. Eight patients (10%) could not be decannulated because of airway obstruction. Five of these outgrew their obstruction, 2 required surgery, and 1 continues to be evaluated for laryngeal reconstruction. CONCLUSION Pediatric tracheostomy can be performed safely with no perioperative complications and acceptable chronic morbidity.-->