A 20 YEAR (1971-1990) REVIEW OF TRACHEOSTOMIES IN A MAJOR PEDIATRIC HOSPITAL

Changing trends in the indications for paediatric tracheostomies, with decreasing numbers. of tracheostomies being performed, have been repo rted in the literature. In a retrospective analysis of the period 1971 to 1990 the experience of tracheostomies in children under the age of 15 at Our Lady's Hospital (Dublin) is reviewed. Only 29 tracheostomie s were performed during this time with an increase in numbers (90%) pe rformed during the second 10 year period. The major underlying indicat ion for tracheostomy in both 10 year periods was for the management of an airway problem secondary to congenital abnormalities (65%). In 14 children the operation was performed during the first year of life. Ho wever, while 90% of the children were under the age of one in the peri od 1971-1980 this fell to 26% during 1981-1990. Complications occurred in 41% overall, however, in the under 1 year old group 64% developed complications. There were no deaths as a direct result of the tracheos tomy or its complications, but six children died because of the severi ty of the underlying disease. The average length of time before decann ulation was 2.1 years, with decannulation difficulties occurring infre quently (11%).