Indication-Based Planning for Tracheostomy in Pediatric Intensive Care Units: a Comprehensive Approach

Abstract

Background: Tracheostomy in pediatric intensive care units (PICU) is an important procedure that has become increasingly common in the last decade, reflecting advances in neonatal and pediatric intensive care. Methods: Main clinical diagnoses were grouped according to the organ system involved. Indications for tracheostomy were defined as the main reason for performing a tracheostomy. Patients were categorized into 4 categories according to the indications for tracheostomy. Namely, airway anomalies (AA), central nervous system (CNS) diseases, cardiopulmonary insufficiency (CPI), and neuromuscular diseases (NMD). Results: Nontraumatic neurological diseases were present in 30 patients (43.4%), genetic or metabolic diseases in 15 (21.7%), infection and sepsis in 9 (13%), malignancy in 6 (8.6%), cardiorespiratory disorders in 5 (7.2%), and trauma in 4 (5.7%). In group analysis, there was no difference in the frequency of early and late problems between newborns and older children. Conclusion: The timing of tracheostomy in the PICU is an important factor that has a significant impact on patient outcomes. The available literature provides valuable insight into the potential benefits of early tracheostomy in improving outcomes in critically ill pediatric patients. © 2025 by Mutaz B. Habal, MD.