Tracheostomy among paediatric patients: Our experiences at a tertiary care teaching hospital in Eastern India

Introduction
Tracheostomy is a surgical procedure that has been performed since ancient times. It is a commonly used life-saving surgical procedure among critically ill patients. Children with airway compromise often need tracheostomy.

Aim of the study
There are numerous research papers published for adult tracheostomy with its indications, operative technique, and complications, but the literature for paediatric tracheostomy is much scarcer. Here, we attempt to analyse the indications, complications, and outcomes of tracheostomy among paediatric patients at a tertiary care teaching hospital in Eastern India.

Material and methods
A retrospective study was done among the children who had undergone tracheostomy between May 2008 and June 2018. The data on age, gender, indications, and complications over a 10-year period were analysed. In this study, the children with tracheostomy were classified into: prolonged intubation, upper airway obstruction, neurological diseases, craniofacial anomalies, trauma, and vocal cord paralysis. Children were included in the prolonged intubation category if they needed ventilator support.

Results
There were 88 tracheostomies done among the children in the study period. There were 47 male children (53.40%) and 41 females (46.59%). Age for tracheostomy ranged from seven months to sixteen years, and the mean age of tracheostomy was 8.8 years. The most common indication for tracheostomy was prolonged ventilation (72.27%) followed by airway obstruction (22.72%). Pulmonary pathology was the main cause for prolonged ventilation.

Conclusions
Advanced technique of paediatric anaesthesia and increased awareness for vaccination among children increased the changing indication for tracheostomy from emergency to more elective procedure. Standardisation of the procedure, timing, and exact indications are helping to reduce the mortality related to tracheostomy among paediatric patients.