Objectives: Percutaneous tracheostomy is rarely performed in children, especially in infants. In the present study, we aimed to evaluate the complications and outcomes of PT via the Griggs technique according to the age and size of pediatric patients.
Methods: This study included 110 PICU patients who underwent PT using the Griggs technique between 2012 and 2020. The patients were divided into six groups according to their age, demographic data, primary disease, mean duration of intubation before PT, mean duration of PICU and hospitalization after PT, complications, and decannulation outcomes were compared between these groups.
Results: The mean age and mean weight of the patients were 43.6 ± 58.9 months (1 month-207 months) and 14.6 ± 14.9 kg (2.6-65 kg), respectively. Mean intubation times before the procedures were 64.6 ± 40 days and 38.6 ± 37.9. Thirty-seven (33.6%) infants were under 6 months of age(Group 1). There were no intraoperative complications. Tracheostomy site stenosis was significantly greater in Group 1 than in the other age groups (p = 0.032). Granuloma formation and dermatitis incidence were similar in all age groups.
Conclusion: PT is a safe and feasible procedure even in small infants. The accidental decannulation risk is lower than standard tracheostomy. Interacting with rigid bronchoscopy guidance is essential to perform a safer procedure. The first tracheostomy change after PT in small infants under 6 months of age, the possibility of tracheostomy site (stoma) stenosis should be considered.
Level Of Evidence: 3 Laryngoscope, 135:416-422, 2025.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635133 | PMC |
| http://dx.doi.org/10.1002/lary.31698 | DOI Listing |
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Article Synopsis
- The review discusses the importance of developing effective strategies for using tracheostomy in ICU patients needing extended mechanical ventilation or having airway protection issues.
- Recent findings highlight that tracheostomy can improve patient comfort, ease the weaning process, and help with recovery activities, although it doesn’t decrease mortality and may lead to complications like tracheal stenosis.
- An individualized approach is necessary to determine the optimal timing and technique for tracheostomy, favoring the percutaneous single dilator method with trained personnel when appropriate.
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