Tracheostomy in the young pediatric burn patient

Objective: To evaluate the incidence of complications in comparison with the benefits of tracheostomy in young pediatric burn patients (newborn to 3 years old). Design: Retrospective survey. Setting: Tertiary care burn center. Patients: A total of 1549 consecutive pediatric burn patients, of whom 180 were intubated. Interventions: Tracheostomy was performed in 76 children. Main Outcome Measures: Duration of mechanical ventilation, mortality, respiratory complications, airway complications, and condition of the airway at discharge from the hospital. Results: Seventy-six patients required tracheostomy. Their mean burn size was 34% to tal body surface area and mean length of stay in the hospital was 56 days. There were no perioperative complications. Eight patients (10%) could not be decannulated because of airway obstruction. Five of these outgrew their obstruction, 2 required surgery, and 1 continues to be evaluated for laryngeal reconstruction. Conclusion: Pediatric tracheostomy can be performed safely with no perioperative complications and acceptable chronic morbidity.