Tracheostomy in pediatric burn patients

•Tracheostomy duration in pediatric burn population is independently associated with the extent of burn injury.•Age is not a factor in the duration of tracheostomy.•Tracheostomy related complications are manageable and do not impact the mortality of pediatric burn patients.

BackgroundTracheostomy is often performed in the pediatric burn population to establish secure airways. Tracheostomy is safe in this population, but the duration of tracheostomy may be related to age and extent and severity of burn. We hypothesized that burn related factors and not age determine the time to removal of a tracheostomy in pediatric burn patients.MethodsA 5-year retrospective review was performed for pediatric burn patients (age ≤18 years) who underwent tracheostomy. Patients were divided into three groups by age (group 1: 0 to ≤2 years, group 2: >2 to ≤12 years, group 3: >12 to ≤18 years). Data collected included: age, total body surface area burn injured (TBSA), gender, mechanism of injury, diagnosis of inhalation injury, mortality, time from injury to admission, time from admission to placement of tracheostomy, time of injury to placement of tracheostomy, duration of tracheostomy, days of mechanical ventilation, and tracheostomy related complications.Results45 patients were reviewed. There were no differences in TBSA, length of ICU stay, length of hospital stay, and mortality between the three groups. Additionally, there were no differences in ventilator days and duration of tracheostomy. Multivariate linear regression analysis indicated that TBSA and not age independently increased the duration of tracheostomy.ConclusionTracheostomy duration is dependent on the extent of burn in pediatric burn patients.