Timing of Liberation from Ventilation Assistance and Decannulation in Preterm Infants with Bronchopulmonary Dysplasia after Tracheostomy
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Purpose: We aimed to evaluate the clinical outcomes of preterm infants withbronchopulmonary dysplasia after tracheostomy. Methods: Medical records of preterm infants with bronchopulmonary dysplasia(BPD) requiring tracheostomy who were admitted to the neonatal intensive care unitof Seoul National University Hospital between January 1999 and December 2013 werereviewed. Data on the age at tracheostomy, indication for the tracheostomy, and theclinical outcomes were collected. Results: Of all admitted preterm infants, 24 (1.0%) were treated with tracheostomy,and the median age at tracheostomy was 185 days. Fifteen patients (62.5%) wereweaned from mechanical ventilation after tracheostomy. Of these, 56.5% patientswere weaned from positive pressure ventilation (PPV) within 24 months, and 81.3%within 60 months. The median time from the tracheostomy to off-PPV was 15.9months. Decannulation was achieved in 8 patients (33.3%); of these, 41.5% weredecannulated within 24 months, and 69.9% within 60 months. The median time fromthe tracheostomy to decannulation was 48.8 months. In patients with airway disease,the time from the tracheostomy to off-PPV and decannulation was found to beextended. However, the presence of airway disease was not significantly associatedwith the duration of mechanical ventilation, or with the time to decannulation. The5-year survival rate was 80.2% in preterm infants with BPD requiring tracheostomy. Conclusion: Infants with bronchopulmonary dysplasia occasionally requiretracheostomy for prolonged mechanical ventilation. In cases with airway disease, thetime from the tracheostomy to off-PPV and decannulation tended to increase,although this increase couldn’t reach any statistical significance.
Abstract
Purpose: We aimed to evaluate the clinical outcomes of preterm infants withbronchopulmonary dysplasia after tracheostomy. Methods: Medical records of preterm infants with bronchopulmonary dysplasia(BPD) requiring tracheostomy who were admitted to the neonatal intensive care unitof Seoul National University Hospital between January 1999 and December 2013 werereviewed. Data on the age at tracheostomy, indication for the tracheostomy, and theclinical outcomes were collected. Results: Of all admitted preterm infants, 24 (1.0%) were treated with tracheostomy,and the median age at tracheostomy was 185 days. Fifteen patients (62.5%) wereweaned from mechanical ventilation after tracheostomy. Of these, 56.5% patientswere weaned from positive pressure ventilation (PPV) within 24 months, and 81.3%within 60 months. The median time from the tracheostomy to off-PPV was 15.9months. Decannulation was achieved in 8 patients (33.3%); of these, 41.5% weredecannulated within 24 months, and 69.9% within 60 months. The median time fromthe tracheostomy to decannulation was 48.8 months. In patients with airway disease,the time from the tracheostomy to off-PPV and decannulation was found to beextended. However, the presence of airway disease was not significantly associatedwith the duration of mechanical ventilation, or with the time to decannulation. The5-year survival rate was 80.2% in preterm infants with BPD requiring tracheostomy. Conclusion: Infants with bronchopulmonary dysplasia occasionally requiretracheostomy for prolonged mechanical ventilation. In cases with airway disease, thetime from the tracheostomy to off-PPV and decannulation tended to increase,although this increase couldn’t reach any statistical significance.
참고문헌 (21)
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