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Traqueostomia pediátrica : relato de uma série de casos

Authors: Fraga, José Carlos Soares de; Contelli, Fábio H.Á.; Kruel, Juliana Rosito Pinto; Costa, Eduardo Corrêa; Backes, Ariane Nádia;

Traqueostomia pediátrica : relato de uma série de casos

Abstract

Objetivo: Determinar a faixa etária, indicações e complicações de traqueostomia realizada em crianças até 12 anos de idade. Métodos: Revisão retrospectiva de 26 crianças submetidas à traqueostomia no período de novembro de 1999 ajulho de 2003, em hospital geral terciário. Resultados: A idade média das crianças foi de 32 meses; 17 (65,4%) eram menores de 1 ano. O procedimento foi eletivo em 20 (76,9%) e de emergência 6 (22,1 %). As principais indicações foram ventilação mecânica prolongada em 13 (50%), estenose subglótica em 5 (19,3%) e malformações congênitas em 4 (15,4%). As complicações foram tecido de granulação no traqueostoma em 7 (26,9%), hemorragia em 3 (11,5%), obstrução da cânula em 3 (11,5%), enfisema subcutâneo em 2 (7,7%), pneumotórax em 2 (7,7%), decanulaçao acidental em 2 (7,7%), estenose laríngea em 1 (3,8%) e infecção da ferida operatória em 1 (3,8%). Não foram observadas diferenças significativas entre as complicações observadas nos procedimentos eletivos e de urgência. Treze pacientes morreram por complicações não relacionadas à traqueostomia; onze (42,2%) permaneceram com traqueostomia, e 2 (7,7%) foram decanulados. Conclusões: Nos últimos anos ocorreram mudanças nas indicações e faixa etária das crianças submetidas à traqueostomia: ela é mais comumente realizada em crianças menores de um ano, e mais freqüentemente devido à intubação prolongada. A traqueostomia é um procedimento seguro quando é realizada por cirurgião treinado com a técnica cirúrgica e com cuidados pós-operatórios de hospital terciário de referência.

Objective: To determine age of surgery, indications and complications of tracheostomy in children until12 years old. Method: Retrospective review of 26 children submitted to tracheostomy from November 1999 to July 2003 at a tertiary general hospital. Results: The mean age was 32 months; 17 (65.4%) were under 1 year old. 1n 20 (76.9%) the procedure was elective, whereas in 6 (22.1%) it was performed as emergency. The main indications of tracheostomy were prolonged mechanical ventilation in 13 patients (50%), subglottic stenosis in 5 (19.3%) and congenital malformations in 4 (15.4%). The most common complications were granulation at the site of the stoma in 7 (26.9%), bleeding in 3 (1l.5%) , blockage of the cannula in 3 (11.5%), subcutaneous emphysema in 2 (7.7%), pneumothorax in 2 (7.7%), accidental decannulation in 2 (7. 7%), larynx stenosis in 1 (3.8%), surgical wound infection in 1 (3.8%). Regarding complications , it was not observed any significam difference between elective and emergency procedures. Thirteen patients (50%) died due to complications not related to the tracheostomy; eleven (42.2%) kept the tracheostomy, and 2 (7.7%) were decannulated. Conclusions: In the last few years there were changes in pediatric tracheostomy. It is being indicated more often in children under one year old, and more recently due to prolonged intubation. Tracheostomy is a safe procedure when performed by trained surgeon with appropriate technique anel postoperative care at tertiary hospital.

Keywords

Pediatria, Tracheostomy, Prolonged intubation, Criança, Subglottic stenosis, Traqueostomia

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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