FATAL COMPLICATIONS IN PEDIATRIC-PATIENTS WITH TRACHEOTOMY

Background: Tracheotomy in the pediatric patient has become a routine procedure since the late 19 th century, when it was used in treating d iphtheria. Although underlying diseases have changed, the child with a n artificial airway still faces numerous risks, This study investigate s fatal complications in 280 patients with tracheostomy who were seen in the Dr. von Haunersches Kinderspital for laryngo-tracheo-bronchosco py. Method: Data was acquired from patients' records of the Dr. von Ha unersches Kinderspital acid communications with other institutions. Re sults: Nineteen deaths were investigated. Three patients died of acute cannula obstruction although hospitalized in different institutions. Two patients who died at home may also have suffered cannula obstructi on, although this could not be verified. The majority of patients succ umbed to the underlying disease. Conclusions: Permanent close supervis ion or monitoring at all times is critical to prevent cannular related deaths. Our results are compared with major series in other studies. In addition, we propose a booklet for the pediatric tracheotomy patien t to document patient data and examination findings, e. g. type and si ze of cannula, duration of cannulation, laryngotracheometry, and compl ications. Its purpose will be to support communication between patient s, parents, pediatricians, pediatric surgeons, and otolaryngologists. Furthermore, this booklet will help in evaluating risks, which may enc ounter pediatric tracheostomy patients, thereby enabling future studie s.