The evaluati̇on of pati̇ents wi̇th tracheostomy followed i̇n the pedi̇atri̇c i̇ntensi̇ve care uni̇t between 2013 and 2019

Background: Tracheostomy is an increasing surgical procedure to be applied to critically ill patients of all ages within the indication in intensive care units. The most common causes of tracheostomy are prolonged mechanical ventilation and upper respiratory airway obstruction. In this study, 61 patients who underwent tracheostomy in the Pediatric Intensive Care Unit (PICU); demographic features, concomitant diseases, timing of the procedure, complications, patient outcomes and determining the factors affecting these results of patients were evaluated. Method: 61 patients between the ages of 1 month and 18 years, followed-up and treated in PICU between 2013 and 2019, and underwent surgical tracheostomy were included in our study. Medical records of the patients were examined retrospectively. Distribution of patients by age, gender, age, primary diagnosis when taken into intensive care, indication for tracheostomy, presence of additional disease, timing of tracheostomy (early / late), respiratory support before and after tracheostomy, duration of intensive care, development of complications (peri-operative/post-operative), decannulation status, mortality and discharging were recorded. Results: Of the 61 patients included in the study, 52% were male and 48% were female. 52,5% of the patients were in preschool age (25-84 months). Concomitant chronic disease was present in 88,5% of patients. The most common tracheostomy indication was prolonged intubation with 39,3%. It was determined that 44,3% of the patients had a primary diagnosis before tracheostomy as neuromuscular diseases. It was observed that 77% of our patients had late tracheostomy (21 days and later). No complications developed in 63,9% of our patients. Complications developed in 14,8% of our patients in the perioperative and in 31,1% in the postoperative period. Decanulation was performed in 9,8% of our patients. On average, it was observed that our patients received mechanical ventilation support for 47,34 days before tracheostomy. 44,3% of our patients were extubated. 45,9% of our patients were died and 92,8% of exitus was developed in the PICU. Conclusion: In conclusion, despite the fact that most of our patients are in preschool age and have accompanying chronic diseases, our complication rates were low. Although tracheostomy was performed due to prolonged intubation to most of our patients, despite the fact that 9,8% of all our patients could be decannulated and 45,9% of them were died. Tracheostomy is still a surgical procedure that is frequently used in PICUs and facilitates discharging from PICU. Keywords: Child, Intensive Care, Tracheostomy, Complication,