Children with Single Cardiac Ventricles and Tracheostomy

What is it about?

Decision-making surrounding tracheostomy in children with single ventricle physiology can be complicated, prolonged, and is frequently fraught with decisional conflict, in part due to the paucity of published data describing clinical outcomes. Long-term outcome data are currently available from single-center studies for children with single ventricle physiology undergoing tracheostomy for chronic ventilation. Collaborative Research from the Pediatric Cardiac Intensive Care Society (CoRe-PCICS) undertook a multicenter cohort study to describe contemporary outcomes of children with single ventricle physiology who undergo tracheostomy.

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Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

The multicenter data from 99 patients who were cared for at 21 participating institutions from 2010 to 2021 show that for patients with single ventricle physiology who undergo tracheostomy, mortality is high, with increased hazard of death in children with non-respiratory indications for tracheostomy or prolonged mechanical ventilation prior to the procedure. The study also shows that favorable outcomes are possible for some children with single ventricle physiology who undergo tracheostomy, though appropriate patient selection and careful attention to tracheostomy timing are likely important determinants toward achieving this goal. For clinicians and families caring for these fragile children, this multicenter data can be utilized to inform decision-making surrounding tracheostomy in the setting of single ventricle physiology.

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