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J Pediatr Intensive Care 2019; 08(02): 078-082
DOI: 10.1055/s-0038-1676117
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Pediatric Long-Term Endotracheal Intubation and Role for Tracheostomy: Patient and Provider Factors

Kassi Ackerman
1   Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
,
Taylor P. Saley
1   Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States
,
Nasir Mushtaq
2   Department of Family and Community Medicine, School of Community Medicine, Oklahoma City, Oklahoma, United States
3   Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
,
Timothy Carroll
4   Department of Pediatric Critical Care and Sedation, The Children's Hospital at Saint Francis Medical Center, Tulsa, Oklahoma, United States
› Author Affiliations
Further Information

Publication History

13 September 2018

17 October 2018

Publication Date:
26 November 2018 (online)

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Abstract

Tracheostomy provides an alternative to long-term intubation in patients with respiratory failure, but there is little guidance for its use in pediatric patients. Our study used provider surveys of pediatric intensive care physicians managing patients intubated longer than 14 days to evaluate accuracy of physician estimates for total intubation time and the impact of medical history and illness category on determining tracheostomy placement. Providers' ability to estimate length of intubation was found to be highly inaccurate. With delayed tracheostomy conferring increased risk and mortality, better recommendations regarding indication and timing of pediatric tracheostomy placement are needed.

Keywords

pediatric - tracheostomy - intubation
 

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