Tracheostomy in children: A population‐based experience over 17 years
Why this work is in the frame
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Bibliographic record
Abstract
INTRODUCTION: Tracheostomy is a lifesaving intervention with numerous complications. OBJECTIVES: We describe the natural history of tracheostomy in children in a defined geographical area over a 17-year period. Our primary aim is to stress the need for a consensus on pediatric tracheostomy care. METHODS: This retrospective study reviewed the charts of 72 children who had tracheostomy between January 1990 and January 2007. Indications for the procedure were divided into 3 groups: (1) upper airway obstruction at a well-defined anatomic site (32 patients); (2) upper airway obstruction with a complex medical condition (24 patients); and (3) need for an access to the lower airway for long-term ventilation and pulmonary care with normal airway anatomy (16 patients). RESULTS: The most common indication for tracheostomy was upper airway obstruction due to subglottic stenosis (15 patients, 21%) or as part of a complex craniofacial syndrome (15 patients, 21%). The duration of intubation prior to tracheostomy and the duration of hospitalization after tracheostomy varied markedly. Tracheocutaneous fistulae complicated 15 of the 38 (37%) decannulated patients. Tracheostomy infection occurred in 90% of the patients and tracheal granulation in 56%. Eleven (15%) deaths occurred, 10 were due to the underlying medical illness and 1 to a mucous plug. CONCLUSION: The complications of tracheostomy in children are substantial. Surveillance and prompt interventions are necessary to overcome life-threatening sequelae. A multidisciplinary (medical-surgical) approach provides better care for these highly vulnerable children. A consensus on pediatric tracheostomy care is needed.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it