Tracheostomy in the Extremely Premature Neonate: A Multi-Institutional Study.
Otolaryngol Head Neck Surg
; 162(4): 559-565, 2020 Apr.
Article
em En
| MEDLINE
| ID: mdl-32093576
ABSTRACT
OBJECTIVE:
(1) To describe characteristics associated with tracheostomy placement and (2) to describe associated in-hospital morbidity in extremely premature infants. STUDYDESIGN:
Pooled retrospective analysis of charts.SETTING:
Academic children's hospitals. SUBJECTS ANDMETHODS:
The patient records of premature infants (23-28 weeks gestational age) who underwent tracheostomy between January 1, 2012, and December 31, 2017, were reviewed from 4 academic children's hospitals. Demographics, procedural morbidity, feeding, respiratory, and neurodevelopmental outcomes at the time of transfer from the neonatal intensive care unit (NICU) were obtained. The contribution of baseline characteristics to mortality, neurodevelopmental, and feeding outcomes was also assessed.RESULTS:
The charts of 119 infants were included. The mean gestational age was 25.5 (95% confidence interval, 25.2-25.7) weeks. The mean birth weight was 712 (671-752) g. Approximately 50% was African American. The principal comorbidity was chronic lung disease (92.4%). Overall, 60.5% of the infants had at least 1 complication. At the time of transfer, most remained mechanically ventilated (94%) and dependent on a feeding tube (90%). Necrotizing enterocolitis increased the risk of feeding impairment (P = .002) and death (P = .03).CONCLUSIONS:
Tracheostomy in the extremely premature neonate is primarily performed for chronic lung disease. Complications occur frequently, with skin breakdown being the most common. Placement of a tracheostomy does not seem to mitigate the systemic morbidity associated with extreme prematurity.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Traqueostomia
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Doenças do Prematuro
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article