Is Routine Chest X-ray Following Tracheostomy in Children Really Needed?

Sunday, September 29, 2024

10:12 AM – 10:18 AM EDT

Location: MBCC, 225

Disclosure(s):

Zion Ben Gvili, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ory Madgar, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Tracheostomy is a common surgical procedure. In most institutes, routine post-tracheostomy chest radiography is performed to evaluate for complications such as pneumothorax, pneumomediastinum, and tube malposition. It is done despite there being no strong evidence supporting such a standard practice. In fact, in recent years, several studies questioned the need for such practice in the adult literature. While some argue it is a safe practice, others feel it is an over utilized, low yield investigation.
Our study aimed to examine the role of routine post-tracheostomy chest X-rays in children.

Methods: A retrospective analysis of all pediatric patients undergoing tracheostomy at a tertiary care center, between January 1, 2013 and August 31, 2022.

Results: During the study period, 168 pediatric patients underwent tracheostomy, 56% were a bedside procedure. Patients’ ages ranged from 2 weeks to 17 years of age, with a median age of 15 months. Each patient underwent a chest x-ray after the procedure and each image was interpreted by radiologists. 28 patients (14%) had new findings on chest x-rays after the procedure, and most had worsening findings that were noticed on chest x-rays before the procedure. None of our patients suffered from pneumothorax, pneumomediastinum, or tube malposition. None of the chest x-ray results led to any change in patient management.

Conclusions: As our results suggest, the practice of routine post-tracheostomy chest x-ray in children is debatable owing to its low-yield and minimal impact on clinical management.

Presenting Author(s)

ZG

Zion Ben Gvili, MD

Otolaryngology head and neck surgery resident, PGY 6
Sheba Medical Center
Ganei tikva, HaMerkaz, Israel

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

SH

Sholem Hack

Sheba Medical Center, United States

Disclosure information not submitted.
EC

Eldar Carmel

Disclosure information not submitted.
CP

Chilaf Peled, MD

Sheba Medical Center, United States

Disclosure information not submitted.

Senior Author(s)

Ory Madgar, MD

Pediatric Otolaryngologist
Department of Otolaryngology, Head and Neck Surgery, the Sheba Medical Center, Tel-Hashomer, Israel
Ramat Gan, Tel Aviv, Israel

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.