Illustration of the current practice and outcome comparison of early versus late tracheostomy after pediatric ECMO
| Autor: | Michele Astle, Karl F. Welke, Sandeep Tripathi, Girish G. Deshpande, Anil Kumar Swayampakula, Yanzhi Wang |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Biomedical Engineering Medicine (miscellaneous) Bioengineering 030204 cardiovascular system & hematology Intensive Care Units Pediatric law.invention Biomaterials 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Tracheostomy law Extracorporeal membrane oxygenation medicine Cardiopulmonary bypass Humans Intensive care medicine Child Heart Failure business.industry Infant Newborn Infant General Medicine Length of Stay Respiration Artificial 030228 respiratory system Current practice Cardiorespiratory failure Child Preschool Female business Respiratory Insufficiency |
| Zdroj: | The International journal of artificial organs. 43(11) |
| ISSN: | 1724-6040 |
| Popis: | Objective: Pediatric extracorporeal membrane oxygenation typically necessitates protracted ventilator support, yet not much is known about the use of tracheostomy in the pediatric subpopulation. The study was designed with an objective to quantify the prevalence of tracheostomy in children with respiratory/cardiac failure requiring extracorporeal membrane oxygenation and to compare outcomes for patients undergoing early, late, and no tracheostomy. Methods: Data of patients 21 days after intensive care unit admission. Results: Data were analyzed for 2127 patients meeting inclusion and exclusion criteria. Five percent (107/2127) underwent a tracheostomy. Of these, 28% (30/107) underwent early and 72% (77/107) late tracheostomy. A higher mortality was found in the no tracheostomy group (41.3%) compared to early (13.3%) and late tracheostomy (14.3%) groups. Late tracheostomy was associated with 2.4 times the expected intensive care unit length of stay and 1.87 times the expected ventilator days as compared to patients with no tracheostomy. Early tracheostomy was associated with a shorter intensive care unit length of stay (p value Conclusions: Late tracheostomy (>21 days) is associated with worse outcomes in the cohort of children who underwent Pediatric extracorporeal membrane oxygenation compared to patients who did not undergo tracheostomy. Early tracheostomy is associated with shorter intensive care unit stay and ventilator duration when compared to late tracheostomy. |
| Databáze: | OpenAIRE |
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