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KMID : 1039920140210040238
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Neonatal Medicine
2014 Volume.21 No. 4 p.238 ~ p.243
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Timing of Liberation from Ventilation Assistance and Decannulation in Preterm Infants with Bronchopulmonary Dysplasia after Tracheostomy
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Kim Hye-Rim
Choi Jung-Yoon
Kim Sae-Yun
Lee Byoung-Kook
Jung Young-Hwa
Heo Ju-Sun
Shin Seung-Han
Kim Ee-Kyung
Kim Han-Suk
Choi Jung-Hwan
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Abstract
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Purpose: We aimed to evaluate the clinical outcomes of preterm infants with bronchopulmonary dysplasia after tracheostomy.
Methods: Medical records of preterm infants with bronchopulmonary dysplasia (BPD) requiring tracheostomy who were admitted to the neonatal intensive care unit of Seoul National University Hospital between January 1999 and December 2013 were reviewed. Data on the age at tracheostomy, indication for the tracheostomy, and the clinical 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%) were weaned from mechanical ventilation after tracheostomy. Of these, 56.5% patients were 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 15.9 months. Decannulation was achieved in 8 patients (33.3%); of these, 41.5% were decannulated within 24 months, and 69.9% within 60 months. The median time from the 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 be extended. However, the presence of airway disease was not significantly associated with the duration of mechanical ventilation, or with the time to decannulation. The 5-year survival rate was 80.2% in preterm infants with BPD requiring tracheostomy.
Conclusion: Infants with bronchopulmonary dysplasia occasionally require tracheostomy for prolonged mechanical ventilation. In cases with airway disease, the time from the tracheostomy to off-PPV and decannulation tended to increase, although this increase couldn’t reach any statistical significance.
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KEYWORD
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Tracheostomy, Bronchopulmonary dysplasia, Preterm infant
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