Tracheostomy trends in paediatric intensive care.
Jason PowellHannah L BuckleyRachel AgbekoMalcolm BrodlieSteven PowellPublished in: Archives of disease in childhood (2020)
Paediatric tracheostomy is most commonly performed in children on the paediatric intensive care unit (PICU) to facilitate long-term ventilation. We sought to identify trends in UK tracheostomy practice in PICUs. Data were analysed from 250 261 admissions, including 4409 children tracheostomised between 2003 and 2017. The incidence of tracheostomy in 2017 was approximately half that in 2003 (incidence rate ratio=0.48, 95% CI 0.40 to 0.57). The percentage of patients tracheostomised during a PICU admission, as a proportion of all admissions, was 2.44% (n=319) in 2003 and reduced to 0.97% (n=180) in 2017. Nevertheless, we identified great variability in practice between different PICUs with tracheostomy rates between 0.0% and 4.0% of all admissions. Risk-adjusted PICU mortality was comparable between tracheostomised children and all admissions to PICU.
Keyphrases
- mechanical ventilation
- intensive care unit
- emergency department
- young adults
- risk factors
- primary care
- acute respiratory distress syndrome
- healthcare
- respiratory failure
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- quality improvement
- type diabetes
- cardiovascular events
- coronary artery disease
- cross sectional
- extracorporeal membrane oxygenation
- data analysis