Neonates and infants traсheostomy

Abstract

Tracheostomy is a relevant surgical operation prescribed amid a number of pathologies diagnosed in children. Nowadays obstruction of the upper respiratory tract, the need of extended intubation, sanitation of the tracheobronchial tree are the main causes of tracheostomy in children. This article contains a retrospective analysis of medical histories of neonates and infants that received treatment in Saint-Petersburg State Pediatric Medical University Hospital's anesthesiology unit over the period 2016-2018. The main purpose of the article is to analyze the causes of tracheostomy and its results in newborns and infants. The authors conducted a survey on the indications for tracheostomy, as well as on its outcomes. The study produced the following results. The investigation involved 11 patients, including 3 girls and 8 boys. The minimum gestation period was 33 weeks, the maximum 41. The average gestation period was 37.7 ± 1.8 weeks. The age of performance of tracheostomy varied from 2 to 11 weeks, and made up 9+4 weeks on average. All patients (100%) had damage to the central nervous system (CNS), seven patients (91%) had congenital defects of the cardiovascular system and lower respiratory tract. Seven children also had lower respiratory tract pathologies requiring respiratory support. One child with multiple malformations in the study of the karyotype was confirmed by the presence of the Edwards genetic syndrome. The causes for the intervention were determined by the combined severity of multiple birth defects and other neurological and somatic diseases. In the outcome of tracheostomy 8 patients (73%) adapted to spontaneous breathing through the tracheostomy and were transferred to other departments and hospitals for further nursing. Mortality due to the imposition of tracheostomy or the development of post tracheostomy complications was absent.