ORCID

0000-0003-3731-5594 (Lucas)

Document Type

Article

Publication Date

2025

DOI

10.1002/ohn.1306

Publication Title

Otolaryngology-Head and Neck Surgery

Volume

Advance online publication

Pages

10 pp.

Conference Name

AAO-HNSF-2023 Annual Meeting & OTO Experience, September 30-October 4, 2023, Nashville, Tennessee

Abstract

Objective

(1) To investigate weight as an alternative guide for trach tube choice. (2) Evaluate complications 3-month posttracheostomy and associations with patient and trach tube factors.

Study design

Retrospective cohort study.

Setting

Single academic medical center.

Methods

Patients < 2 years old who underwent tracheostomy placement from 2017 to 2022 were identified. Associations between trach characteristics, trach size/length, chest x-ray (CXR) and intraoperative endoscopy measurements, and complications within 3 months posttracheostomy placement were evaluated.

Results

In total, 68 patients were included in the study, with a median age of 4 months (range: 1 day to 1.74 years) and weight of 4.1 kg (range: 1.8-11.6 kg) at the time of the procedure. The length of the trachea measured on CXR was more closely associated with weight (ρ = 0.403, P = .0007) than with age (ρ = 0.291, P = .02). Major complications, including accidental decannulation or death, occurred in 16/68 (24%) patients and minor events, including skin breakdown or difficult trach change, occurred in 19/68 (27.9%) patients and were not associated with age or weight. Major events were associated with male sex (P = .006) and shorter distance from the trach to the carina (P = .03).

Conclusion

In pediatric patients with a tracheostomy, the anatomical distance between the thoracic inlet and carina on CXR was more strongly associated with weight rather than age. Postoperative complications were not associated with age or weight, but rather with male sex and shorter distance from the trach to the carina. When selecting a trach size for patients younger than 2 years, a weight-based algorithm may aid in reducing posttracheostomy complications.

Rights

© 2025 The Authors.

This is an open access article under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Original Publication Citation

Eljamri, S., Lucas, J., Shaffer, A., Hashimi, B., Rushchak, M., & Padia, R. (2025). Size of pediatric tracheostomy tube and predictors of postoperative complications. Otolaryngology–Head and Neck Surgery. Advance online publication. https://doi.org/10.1002/ohn.1306

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