Repositorio UFRO · Omeka S

Factors Associated With Accidental Decannulation in Tracheostomized Children

Primer Autor	Villarroel, Gregory S.
Co-autores	Faundez, Macarena Jalil, Yorschua F. Oyarzun, Ignacio J. Fernandez, Tiziana R. Baranao, Patricio, I Mendez, Mireya P. Munoz, Sergio R.
Título	Factors Associated With Accidental Decannulation in Tracheostomized Children
Editorial	DAEDALUS ENTERPRISES INC
Revista	RESPIRATORY CARE
Lenguaje	en
Resumen	BACKGROUND: Tracheostomy has many benefits for pediatric patients in the ICU, but it is also associated with complications. Accidental decannulation (AD) is a frequent complication and cause of mortality in this population. Our study aimed to determine the factors associated with AD in tracheostomized pediatric subjects. METHODS: This was a case-control study with 1:2 allocation ratio. Participants were tracheostomized children hospitalized in a prolonged mechanical ventilation hospital between 2013-2018. Each child who experienced decannulation during the study period was included as a case at the time of the event. Controls were obtained from the same population and were defined as subjects without an AD event during the same period. RESULTS: One hundred forty patients were hospitalized at Josefina Martinez Hospital at the time, of whom 41 were selected as cases and 82 as controls. Median (interquartile range) age was 20 (12-36) months, being 60% male. The median time from tracheostomy placement to AD event was 364 (167-731) d. Eighty-four percent of subjects were mechanically ventilated. AD mainly occurred by self-decannulation (53.7%). The risk of AD was higher in children who reached the midline in a sitting position (odds ratio 9.5 [95% CI 1.59-53.90]), inner di-ameter (ID) tracheostomy tube size <= 4.0 mm (odds ratio 5.18 [95% CI 1.41-19.06]), and who had been hospitalized in hospital rooms with a low ratio of nursing staff for each subject (1 nurse to 4 subjects) (odds ratio 4.48 [95% CI 1.19-16.80]). CONCLUSIONS: Factors associ-ated with a higher risk of AD in tracheostomized children included the ability to reach the midline in a sitting position, the use of a smaller tracheostomy tube (<= 4.0 mm ID), and lower supervision from staff.
Fecha Publicación	2023
Tipo de Recurso	artículo original
doi	10.4187/respcare.09673
Formato Recurso	PDF
Palabras Claves	child tracheostomy accidental decannulation risk factors case control
Ubicación del archivo	http://dx.doi.org/10.4187/respcare.09673
Categoría OCDE	Medicina general e interna Sistema respiratorio
Materias	niño traqueotomía decanulación accidental factores de riesgo control de caso
Página de inicio (Recomendado-único)	173.0
Página final (Recomendado-único)	179
Identificador del recurso (Mandatado-único)	artículo original
Versión del recurso (Recomendado-único)	versión publicada
Derechos de acceso	acceso abierto
Access Rights	acceso abierto
Id de Web of Science	WOS:000935794200002
ISSN	0020-1324
Tipo de ruta	dorado
Categoría WOS	Medicina general e interna Sistema respiratorio