The purpose of this study was to determine the safety and efficacy of percutaneous versus open
tracheostomy in the pediatric
trauma population. A retrospective chart review was conducted of all
tracheostomies performed on
trauma patients younger than 18 years for an 8-year period. There was no difference in the incidence of brain, chest, or
facial injury between the open and percutaneous
tracheostomy groups. However, the open group had a significantly lower age (14.2 vs. 15.5 years; P < 0.01) and higher injury severity score (26 vs. 21; P = 0.015). Mean time from injury to
tracheostomy was 9.1 days (range, 0 to 16 days) and was not different between the two methods. The majority of open
tracheostomies were performed in the operating room and, of percutaneous
tracheostomies, at the bedside. Concomitant
feeding tube placement did not affect complication rates. There was not a significant difference between complication rates between the two methods of
tracheostomy (percutaneous one of 29; open three of 20). Percutaneous
tracheostomy can be safely performed in the injured older child.