Effectiveness of tracheotomy on tissue oxygenation and acid-base balance in pediatric patients

Objective: Tracheotomy is an effective method to improve oxygenation in patients receiving prolonged mechanical ventilation. These patients are monitored with pulse oximetry and blood gas parameters. These parameters, however, cannot effectively reflect the changing tissue oxygenation. This study aimed to determine the effect of tracheotomy on tissue oxygenation and acid-base balance in pediatric patients. Methods: This retrospective study included 46 patients who underwent tracheotomy between 2017 and 2019 for long-term mechanical ventilation in the pediatric intensive care unit at a state hospital. In the study, the blood gas parameters of the patients before and after the tracheotomy were compared. Results: The mean age of the patients was 2.39 years. The tissue oxygen content (ctO2) value after tracheotomy (14.60±2.42) was higher than the value before tracheotomy (13.82±2.77). Although there were no significant differences in the oxygen saturation (sO2) and partial pressure of oxygen values, decreases in pH and actual bicarbonate values were observed (mean differences were −0.026 and −3.06, respectively). It was also determined that after tracheotomy, both the base excess of extracellular fluid and base excess of blood values reduced to the normal range (±2 mmol/L) (mean differences −3.570 and −3.076, respectively). Conclusion: Tracheotomy in pediatric patients increased tissue oxygenation and improved metabolic alkalosis. It was concluded that in addition to sO2, tissue oxygenation might be monitored by calculating the ctO2.