Complications of neonatal tracheostomy: A 5-year review

OBJECTIVE. Study the complication rate of tracheostomy in premature infants and identify contributing factors. SETTING: Two university-based tertiary care children's hospitals. METHODS., The charts of 55 neonates who underwent tracheostomy. between January 1997 and December 2002 were reviewed. Group I included 32 infants born weighing < 1000 grams. Group 2 included 23 infants born weighing : 1000 grams. RESULTS., Group 1 infants had a higher incidence of comorbidities related to prematurity. Thirty-eight infants underwent tracheostomy due to ventilatory dependence, 13 for airway obstruction, and 4 for neurologic debilitation. Sixteen infants (29%) had a complication related to tracheostomy. There was no tracheostomy-related mortality. CONCLUSIONS: Tracheostomy in the preterm infant has the potential for significant morbidity. Meticulous technique, surgeon experience and specialized care may play a role in reducing the complication rate. Complications are usually minor and do not require additional surgical intervention.