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Tracheostomy trends in paediatric intensive care
  1. Jason Powell1,2,
  2. Hannah L Buckley3,
  3. Rachel Agbeko4,
  4. Malcolm Brodlie1,5,
  5. Steven Powell2
  1. 1Institute of Translational and Clinical Research, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
  2. 2Paediatric Otolaryngology, Great North Children's Hospital, Newcastle Upon Tyne, Tyne and Wear, UK
  3. 3Paediatric Intensive Care Audit Network, University of Leeds, Leeds, West Yorkshire, UK
  4. 4Paediatric Intensive Care, Great North Children's Hospital, Newcastle Upon Tyne, Tyne and Wear, UK
  5. 5Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle Upon Tyne, Tyne and Wear, UK
  1. Correspondence to Jason Powell, Newcastle University Institute of Cellular Medicine, Newcastle upon Tyne NE1 4LP, UK; jason.powell{at}newcastle.ac.uk

Abstract

Paediatric tracheostomy is most commonly performed in children on the paediatric intensive care unit (PICU) to facilitate long-term ventilation. We sought to identify trends in UK tracheostomy practice in PICUs. Data were analysed from 250 261 admissions, including 4409 children tracheostomised between 2003 and 2017. The incidence of tracheostomy in 2017 was approximately half that in 2003 (incidence rate ratio=0.48, 95% CI 0.40 to 0.57). The percentage of patients tracheostomised during a PICU admission, as a proportion of all admissions, was 2.44% (n=319) in 2003 and reduced to 0.97% (n=180) in 2017. Nevertheless, we identified great variability in practice between different PICUs with tracheostomy rates between 0.0% and 4.0% of all admissions. Risk-adjusted PICU mortality was comparable between tracheostomised children and all admissions to PICU.

  • ent
  • intensive care
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Footnotes

  • Twitter @RachelAgbeko

  • Contributors JP, HLB, RA, MB and SP designed the study. JP and HLB performed the data analysis. JP, HLB, RA, MB and SP wrote the manuscript. All authors reviewed and approved the manuscript.

  • Funding The Paediatric Intensive Care Audit Network (PICANet) in collaboration with the Universities of Leeds and Leicester with the support of the paediatric intensive care community. MB is supported by an MRC Clinician Scientist Fellowship (MR/M008797/1). The research was supported by the National Institute for Health Research Newcastle Biomedical Research Centre based at Newcastle Hospitals NHS Foundation Trust and Newcastle University. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests MB: not related to this work: investigator-led research grants from Pfizer and Roche Diagnostics; speaker fees paid to Newcastle University from Novartis, Roche Diagnostics and TEVA. Travel expenses to educational meetings from Boehringer Ingelheim and Vertex Pharmaceuticals. JP, RA, HLB declare no conflicts of interest.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. Yearly summary data on UK PICU practice are published by PICANet and are freely available to view via https://www.picanet.org.uk Further detailed data can be requested through data requests to the PICANet team.

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