Report an error   
Advanced Search

Timing of Tracheostomy, Weaning from Mechanical Ventilation and Duration of Hospitalization among a Sample of Pediatric Patients.


Jose Brian A. Ferrolino,
Ryner Jose  .  Carrillo

Related Institution

Department of Otorhinolaryngology, College of Medicine - Philippine General Hospital University of the Philippines Manila

Department of Anatomy, College of Medicine - University of the Philippines Manila

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Otolaryngology Head and Neck Surgery
Publication Date
July-December 2019


OBJECTIVE: To determine if there is a difference in the duration of mechanical ventilation and hospitalization between patients who underwent early compared to late tracheostomy.


Design:                Causal-Comparative (ex post facto) Chart Review

Setting:                Tertiary National University Hospital

Participants:                   Records of 68 pediatric patients who underwent elective tracheostomy from January 1, 2013 to June 30, 2018 were considered for inclusion. Patients were excluded if invasive mechanical ventilation was not done prior to tracheostomy, if they underwent emergency tracheostomy or had incomplete records. Selected patients were categorized in the early tracheostomy group if the procedure was performed within 14 days of mechanical ventilation and late tracheostomy group if performed beyond 14 days. Early post-tracheostomy weaning from mechanical ventilation was defined as less than 7 days from time of tracheostomy.

RESULTS: A total of 21 patients were included, 6 in the early tracheostomy group and 15 in the late tracheostomy group. Although early tracheostomy did not show significant association with shortened post-tracheostomy duration of mechanical ventilation (O.R. 6; C.I. 0.276 to 130.322; p = .476), two-sample t-tests showed the early tracheostomy group had a significantly shorter mean duration of mechanical ventilation and hospitalization compared to the late tracheostomy group (13.17 vs. 54.13 days, p = .0012; 21.17 vs. 66.67 days, p = .0032).

CONCLUSION: Although early tracheostomy does not shorten post-tracheostomy mechanical ventilation support, there is a significant difference in the duration of mechanical ventilation and hospitalization between early and late tracheostomy groups and this may suggest potential benefits of performing tracheostomy earlier in children.


KEYWORDS: tracheotomy; pediatric; mechanical ventilation; hospitalization


1. Lin, C Y, Ting, T T, Hsiao, T Y, Hsu, W C. "Pediatric Tracheostomy: A comparisonof outcomes and lengths of hospitalization between different indications." Int J Pediatr Otorhinolaryngol 34(2): 20-23, July 2019-December 2019
2. Ozmen, S , Ozmen, O A, Unal, O F. "Pediatric tracheostomies: A 37-year experience in 282 children" Int J Pediatr Otorhinolaryngol 73(7): 959 – 961, July 2009
3. Rumbak, M J, Newton, M , Truncale, T , Schwartz, S W, Adams, J W, Hazard, P B. "A prospective randomized study comparing early percutaneous dilational tracheostomy to prolonged translaryngeal intubation (delayed tracheotomy) incritically ill medical patients" Crit Care Med 32(12): 2566, December 2004
4. Adly, A , Youssef, T A, El-Begermy, M M, Younis, H M. "Timing of Tracheostomy in patients with prolonged endotracheal intubation: a systematic review." Eur Arch Otorhinolaryngol 275(3): 679 - 690, March 2017
5. Lee, J H, Koo, C H, Yee, S Y, Kim, E H, Song, I K, Kim, H S. "Effect of early vs late tracheostomy on clinical outcomes in critically ill pediatric patients" Acta Anesthesiol Scand 60(9): 1281 - 128, October 2016
6. Ertugrul, I , Kesici, S , Bayrakci, B , Unal, O F. "Tracheostomy in Pediatric Intensive Care Unit: When and Where?" Iran J Pediatr 26(1): February 2016
7. University of the Philippines; Philippine General Hospital, Department of Otorhinolaryngology. Clinical Practice Guidelines: Tracheostomy and Decannulation. Manila: University of the Philippines Department of Otorhinolaryngology. 2003. 53-60.
8. Holloway, A J, Spaeder, M C, Basu, S . "Association of timing of tracheostomyon clinical outcomes in PICU patients" Pediatr Crit Care Med 16(3): e52 - e58, March 2015
9. Veenith, T , Ganeshamoorthy, S , Standley, T , Carter, J , Young, P . "Intensive Care Unit Tracheostomy: a snapshot of UK practice" Int Arch Med 1(1): 21, October 2008
10. Durbin, C G Jr., Perkins, M P, Moores, L K. "Should tracheostomy be performed asearly as 72 hours in patients requiring prolonged mechanical ventilation?" Respir Care 55(1): 76 – 87, January 2010
11. Wakeham, M K, Kuhn, E M, Lee, K J, Wood, D , McShane, p , Davis, P . "Tracheostomy in children admitted to pediatric intensive care." Arch Dis Child 97(10): 866 - 869, October 2012
12. Wakeham, M K, Kuhn, E M, Lee, K J, McCrory, M C. "Use oftracheostomy in the PICU among patients requiring prolonged mechanicalventilation" Intensive Care Med 40(6): 863 – 870, June 2014

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Society of Otolaryngology-Head and Neck Surgery Fulltext pdf (Download)
Philippine Journal of Otolaryngology Head and Neck Surgery Website Fulltext External Link (View)
Philippine Council for Health Research and Development Fulltext pdf (Request Document)

©2021 HERDIN PLUS. All rights reserved.