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Risk factors associated with the need for a tracheostomy in extremely low birth weight infants.

Abstract

In an attempt to determine the risk factors associated with the need for a tracheostomy in extremely low birth weight (ELBW) infants, a retrospective, case control study was conducted (each infant with a tracheostomy [case] was matched to two controls). Medical records were reviewed for patients' characteristics, risk factors for tracheostomy and outcome. During the study period (June 1996 to Dec 2010), 934 ELBW infants were admitted to our institution and nine infants had a tracheostomy and were matched to 18 controls. There were no differences in birth weight (BW) and gestation age (GA) between cases and controls (828.1 ± 136.2 g vs. 822.0 ± 140.9 g [P = 0.91] and 26.6 ± 1.8 weeks vs. 26.5 ± 1.6 weeks [P = 0.88], respectively). In comparison to their controls, infants with a tracheostomy had a higher rate of intubation (median 13 [11-15] vs. 3 [2-5], P ≤ 0.001), a higher rate of total intubation attempts (median 18 [13-21] vs. 5.5 [3-7], P = 0.001), and more days of mechanical ventilation prior to their tracheostomy (mean 100.7 ± 27.7 vs. 29.2 ± 19.8 days [P < 0.001]). Also infants with a tracheostomy had a higher rate of non-congenital upper airway obstruction (55% [5/9] vs. 0% [0/18]; P = 0.001), a higher rate of chronic lung disease (100% [9/9] vs. 5% [1/18]; P < 0.001) and a higher mortality (44% [4/9] vs. 0% [0/18]; P = 0.007) than their controls. In conclusion, chronic lung disease, multiple intubations and intubation attempts, duration of mechanical ventilation, and non-congenital upper airway obstruction are risk factors associated with tracheostomies in ELBW infants.

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  • Publisher Full Text
  • Authors

    Viswanathan S, Mathew A, Worth A, Mhanna MJ

    Institution

    Division of Neonatology, Department of Pediatrics at MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA

    Source

    Pediatric pulmonology 48:2 2013 Feb pg 146-50

    MeSH

    Airway Obstruction
    Birth Weight
    Bronchopulmonary Dysplasia
    Case-Control Studies
    Female
    Gestational Age
    Humans
    Infant
    Infant, Extremely Low Birth Weight
    Infant, Newborn
    Intubation, Intratracheal
    Male
    Respiration, Artificial
    Retrospective Studies
    Risk Factors
    Severity of Illness Index
    Time Factors
    Tracheostomy
    United States

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22644794