Outcomes of Pediatric Tracheostomy: The Impact of Body Weight on Complications

Background: Pediatric tracheostomy is a critical airway intervention associated with technical challenges and procedure-related complications, particularly in infants and small children. Body weight may influence perioperative risk, yet weight-based outcome data remain limited. Objective: The study aimed to evaluate the impact of body weight on acute complications and the clinical course following pediatric tracheostomy, with a particular focus on low-weight infants. Methods: This retrospective cohort study included 39 pediatric patients who underwent tracheostomy in a tertiary pediatric intensive care unit. Patients were stratified by body weight into three groups. Demographic data, indications, procedural characteristics, acute complications, and clinical outcomes were analyzed. Results: Acute complications occurred in 7 patients, most commonly cannula-related events. Complication rates were higher in patients < 5 kg. Patients < 5 kg had a longer mean hospital stay than the heavier groups. Conclusions: Low body weight showed a clinically relevant trend toward higher technical risk and prolonged hospitalization following pediatric tracheostomy, although statistical significance was not reached in this cohort. Weight-based procedural planning may support safer postoperative management in this vulnerable population.