Abstract
Objectives: Our aim was to determine the treatable causes to increase
the chance of decannulation success. For this purpose we evaluated the
differences between the patients who succesfully decannulated and the
patients who still has tracheostomy. Metods: A retrospective cohort
study was conducted based on medical records of all pediatric patients
with tracheostomy in a single centre. Results: Decannulation was
successfully achieved in 59 patients (34.5%) of total 171 patients with
tracheostomy between the years 2012-2019. Median duration of
tracheostomy was 41.5 and 12 months in patients who remained with
tracheostomy and decannulated respectively. Neurological disorders were
higher in patients remained with tracheostomy, congenital heart disease
and airway abnormalities were higher in decannulated patients. Presence
of bacterial colonization (3.8-fold), history of invasive respiratory
support following tracheostomy (2.9-fold), and having any neurological
disorder and/or comorbidity (5.2-fold) were significantly associated
lower rates of decannulation. Almost 33 % of patients had bacterial
colonization and colonization rates were higher in patients who needed
invasive respiratory support following tracheostomy placement
(p<0.001), patients with feeding/swallowing problems (p=0.005)
and neurological disorders(0.002). There was significant correlation
between duration of tracheostomy and bacterial colonization rates
(p=0.008). But after analysing with logistic regression only having a
neurological disorder was associated with bacterial colonization (OR=
2.9; 95% Cl: 1.15-7.47 p=0.024). Conclusion: While conducting
decanulation assessment, the presence of colonization should be
considered. Future prospective researchs are necessary in order to
determine the role of chronic colonization on decannulation success.