Repositorio
Institucional

Villarroel, Gregory S.

Faundez, Macarena

Jalil, Yorschua F.

Oyarzun, Ignacio J.

Fernandez, Tiziana R.

Baranao, Patricio, I

Mendez, Mireya P.

Munoz, Sergio R.

Factors Associated With Accidental Decannulation in Tracheostomized Children

DAEDALUS ENTERPRISES INC

RESPIRATORY CARE

en

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.

2023

artículo original

10.4187/respcare.09673

PDF

child

tracheostomy

accidental decannulation

risk factors

case control

Medicina general e interna

Sistema respiratorio

niño

traqueotomía

decanulación accidental

factores de riesgo

control de caso

173.0

179

artículo original

versión publicada

acceso abierto

acceso abierto

WOS:000935794200002

0020-1324

dorado

Medicina general e interna

Sistema respiratorio